NICHOLAS TAYLOR DULETZKE
NPI 1417319922
Surgery - Trauma Surgery in Vancouver, WA

NPI Status: Active since March 23, 2016

Contact Information

505 NE 87TH AVE STE 301
VANCOUVER, WA
ZIP 98664
Phone: (360) 514-1854
Fax: (360) 514-6063

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  • Individual
  • Male
  • Years of Experience 10
  • Surgery
  • Trauma Surgery
  • Accepts Insurance
  • Accepts Medicare Approved Payment
  • PECOS Enrolled

About NICHOLAS DULETZKE

This page provides the complete NPI Profile along with additional information for Nicholas Duletzke, a provider established in Vancouver, Washington with a medical specialization in Surgery, focusing in trauma surgery and more than 10 years of experience. He graduated from Oregon Health Sciences University School Of Medicine in 2016. The healthcare provider is registered in the NPI registry with number 1417319922 assigned on March 2016. The practitioner's primary taxonomy code is 2086S0127X with license number MD61281239 (WA). The provider is registered as an individual and his NPI record was last updated 4 years ago.

NPI
1417319922
Provider Name
NICHOLAS TAYLOR DULETZKE
Gender
Male
Entity Type
Individual
Location Address
505 NE 87TH AVE STE 301 VANCOUVER, WA 98664
Location Phone
(360) 514-1854
Location Fax
(360) 514-6063
Mailing Address
30 N 1900 E SALT LAKE CITY, UT 84132
Mailing Phone
(801) 581-6803
Medical School Name
OREGON HEALTH SCIENCES UNIVERSITY SCHOOL OF MEDICINE
Graduation Year
2016
Is Sole Proprietor?
Yes
Enumeration Date
03-23-2016
Last Update Date
06-08-2022
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Location Map

Secondary Locations

  • 30 N 1900 E
    Salt Lake City, UT 84132
    (801) 581-6803

Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Surgery Trauma Surgery

Taxonomy Code
2086S0127X
Type
Allopathic & Osteopathic Physicians
License No.
MD61281239
License State
WA
Taxonomy Description
Trauma surgery is a recognized subspecialty of general surgery. Trauma surgeons are physicians who have completed a five-year general surgery residency and usually continue with a one to two year fellowship in trauma and/or surgical critical care, typically leading to additional board certification in surgical critical care. There is no trauma surgery board certification at this point. To obtain board certification in surgical critical care, a fellowship in surgical critical care or anesthesiology critical care must be completed during or after general surgery residency.

Secondary Taxonomies

The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.

No. Taxonomy Code Type Classification /
Specialization
License No. (State)
1208600000XAllopathic & Osteopathic Physicians

Surgery

MD61281239 (WA)
22086S0102XAllopathic & Osteopathic Physicians

Surgery
Surgical Critical Care

MD61281239 (WA)
3390200000XStudent, Health Care

Student in an Organized Health Care Education/Training Program

 

Insurance Plans Accepted

According to publicly available information the provider might be accepting the following health plans from these health insurance companies:

  • BridgeSpan Standard Bronze Plan - EPO
  • BridgeSpan Standard Gold Plan - EPO
  • BridgeSpan Standard Silver Plan - EPO
  • KP OR Bronze 6000 - EPO
  • KP OR Bronze HSA 7100 - EPO
  • KP OR Gold 0 - EPO
  • KP OR Gold 1750 - EPO
  • KP OR Silver 3000 - EPO
  • KP OR Silver 4000 - EPO
  • KP Oregon Standard Bronze Plan - EPO
  • KP Oregon Standard Gold Plan - EPO
  • KP Oregon Standard Silver Plan - EPO
  • KP OR Family Dental - $100 Ded - EPO
  • Moda Health Affinity Bronze 8000 - EPO
  • Moda Health Affinity Bronze 9000 - EPO
  • Moda Health Affinity Bronze HDHP 7500 - EPO
  • Moda Health Affinity Gold 1000 - EPO
  • Moda Health Affinity Gold 1500 - EPO
  • Moda Health Affinity Gold 250 - EPO
  • Moda Health Affinity Silver 3000 - EPO
  • Moda Health Affinity Silver 3400 - EPO
  • Moda Health Affinity Silver 4500 - EPO
  • Moda Health Affinity Silver 6000 - EPO
  • Premera Blue Cross Alaska One Gold - PPO
  • Premera Blue Cross Preferred Bronze 5800 HSA - PPO
  • Premera Blue Cross Preferred Bronze 6350 - PPO
  • Premera Blue Cross Preferred Gold 1500 - PPO
  • Premera Blue Cross Preferred Silver 4500 - PPO
  • Premera Blue Cross Standard Bronze II - PPO
  • Premera Blue Cross Standard Gold - PPO
  • Premera Blue Cross Standard Silver - PPO
  • Premera Blue Cross Family Dental - PPO
  • Premera Blue Cross Pediatric Dental - PPO
  • Connect 1500 Gold - EPO
  • Connect 6000 Silver - EPO
  • Connect 9800 Bronze - EPO
  • HSA Qualified 7500 Bronze - Choice Network - EPO
  • HSA-E Qualified 7500 Bronze - Signature Network - EPO
  • Providence Oregon Standard Bronze Plan - Choice Network - EPO
  • Providence Oregon Standard Bronze Plan - Signature Network - EPO
  • Providence Oregon Standard Gold Plan - Choice Network - EPO
  • Providence Oregon Standard Gold Plan - Signature Network - EPO
  • Providence Oregon Standard Silver Plan - Choice Network - EPO
  • Bronze 8000 Individual Connect - EPO
  • Bronze Essential 9000 With 4 Copay No Deductible Office Visits Individual Connect - EPO
  • Bronze HSA 7000 Individual Connect - EPO
  • Gold 2300 Individual Connect - EPO
  • Regence Standard Bronze Plan Individual Connect - EPO
  • Regence Standard Gold Plan Individual Connect - EPO
  • Regence Standard Silver Plan Individual Connect - EPO
  • Silver 6500 Individual Connect - EPO

*Please verify directly with this provider to make sure your insurance plan is currently accepted.

Medicare Participation & PECOS Enrollment Status

Nicholas Duletzke is registered with Medicare and accepts claims assignment, this means the provider accepts the approved amount for the cost of rendered services as full payment. Participating providers may not charge beneficiaries more than the approved amount for their services. Please keep in mind that beneficiaries still have to pay a coinsurance or copayment amount for a visit or service.

Nicholas Duletzke is enrolled in PECOS and is eligible to order or refer health care services for Medicare patients. The provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.

What is PECOS?
PECOS is the online Medicare enrollment management system or Provider, Enrollment, Chain and Ownership System. The PECOS system is a database of providers who have registered with CMS as providers or suppliers. PECOS is the primary source of information about verified Medicare professionals. Providers that want to participate in this program need to enroll in PECOS with their NPI number to avoid denied claims.

  • Is the provider registered in PECOS? Yes

  • PECOS PAC ID: 6204192826

    What is the PECOS Associate Control ID?
    A PAC ID is a unique 10-digit number assigned to an individual or organization healthcare provider in PECOS. The PAC ID is used to link together all the provider information, like tax identification numbers and organizational names. A PAC ID can be connected to multiple Enrollment IDs if an individual or organization has enrolled in PECOS more than once.

  • PECOS Enrollment ID: I20220802002699

    What is the Provider Enrollment ID?
    The Enrollment ID is a unique alphanumeric 15-digit code assigned to each new provider's PECOS enrollment application. The Enrollment ID is used to link together all the provider enrollment information like enrollment type, state, provider specialty, and reassignment of benefits.

  • Accepts Medicare Assignment? Yes

    What does it mean "accepts medicare assignment"?
    When a provider accepts Medicare assignment, the provider agrees to be paid directly by Medicare and to accept the payment amount approved by Medicare. Additionally, the provider agrees to not bill patients for more than the Medicare deductible and coinsurance amounts.
    A provider who doesn't accept assignment may charge you up to 15% over the Medicare-approved amount. This is known as the limiting charge. You may have to pay this amount, or it may be covered by another insurer.

  • Eligible to Order or Refer Part B Clinical Laboratory and Imaging: Yes

  • Eligible to Order or Refer Durable Medical Equipment (DMEPOS): Yes

  • Eligible to Order or Refer a Home Health Agency (HHA): Yes

  • Eligible to Order or Refer Power Mobility Devices: Yes

Areas of Expertise

The following services and procedures, recently provided to Medicare patients, illustrate the range of care this provider offers. This list reflects the variety of services available to all patients visiting the practice and is based on 2022 Medicare dataset. In general, the more frequently a provider treats specific conditions or performs particular procedures, the more experienced they become in addressing similar patient needs. The provider has delivered many of the services listed below to Medicare patients. Please note that this list does not include services provided to patients who are not covered by Medicare.

Hernia repair - groin (open)

Hernia repair in the groin area (open) is a surgical procedure to fix a bulge or protrusion, caused by internal tissues pushing through a weak spot in your abdominal wall. In this operation, a small incision is made in the groin area. The protruding tissue is then placed back into the abdomen, and the weakened area is reinforced with stitches or a mesh.

This service was performed for 1-10 patients

Upper gastrointestinal (GI) endoscopy for acid reflux

An upper GI endoscopy is a procedure to examine your esophagus and stomach using a thin, flexible tube called an endoscope. It helps diagnose conditions like acid reflux by identifying any inflammation or damage. It's generally safe, performed under sedation, and takes about 15-30 minutes.

This service was performed for 1-10 patients

Find Provider Hospital Affiliations - Privileges

Doctors and physicians must apply for hospital privileges to treat patients at hospitals. Find out if your doctor has privileges to practice at your preferred hospital by using the hospital affiliation information below based on recent medical claims.

Hospital affiliation is identified through self-reporting data, inpatient, outpatient, physician and ancillary service claims linked by the medical claims NPI number and place of service code. Additionally, to further determine provider hospital affiliation the clinician must have provided services to at least three patients on three different dates in the last 12 months. Nicholas Duletzke is affiliated with the following medical facilities:

Hospital Name Address Phone Hospital Type Overall Rating
PEACEHEALTH SOUTHWEST MEDICAL CENTER400 NE MOTHER JOSEPH PLACE
VANCOUVER, WA 98668
(360) 256-2000Acute Care Hospitals

Reviews for NICHOLAS TAYLOR DULETZKE

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NPI NPI Number Validation

How NPI Validation Works

The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.

To verify the NPI 1417319922, we treat the final digit (2) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 68. The final step is to find the difference between that total and the next multiple of ten (70 - 68 = 2).

Digit-by-digit view

Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.

Pos 1
1
Doubled → 2
Pos 2
4
Unchanged
Pos 3
1
Doubled → 2
Pos 4
7
Unchanged
Pos 5
3
Doubled → 6
Pos 6
1
Unchanged
Pos 7
9
Doubled → 18 → 1 + 8
Pos 8
9
Unchanged
Pos 9
2
Doubled → 4
Check
2
Target digit
Regular digit Doubled digit Check digit

Step 1: Double every other digit from the right

Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.

1 → 2 1 → 2 3 → 6 9 → 18 → 9 2 → 4

Step 2: Add all digits plus the NPI constant

Add the transformed values, the unchanged digits, and the constant 24.

2 + 4 + 2 + 7 + 6 + 1 + 1 + 8 + 9 + 4 + 24 = 68

Step 3: Find the amount needed to reach the next multiple of 10

The next multiple of ten after 68 is 70. The difference is the calculated check digit.

70 - 68 = 2
This NPI is valid
The calculated check digit is 2, which matches the last digit of 1417319922.

Other Providers at the Same Location


The following 19 providers are registered at the same or a nearby location.

Surgery (Trauma Surgery)
505 NE 87TH AVE STE 301
VANCOUVER, WA 98664
Surgery (Trauma Surgery)
505 NE 87TH AVE STE 301
VANCOUVER, WA 98664
Surgery
505 NE 87TH AVE STE 301
VANCOUVER, WA 98664
Nurse Practitioner (Family)
505 NE 87TH AVE STE 301
VANCOUVER, WA 98664
Internal Medicine (Gastroenterology)
505 NE 87TH AVE STE 301
VANCOUVER, WA 98664
Surgery (Surgical Critical Care)
505 NE 87TH AVE STE 301
VANCOUVER, WA 98664
Internal Medicine (Critical Care Medicine)
505 NE 87TH AVE STE 301
VANCOUVER, WA 98664
Internal Medicine (Gastroenterology)
505 NE 87TH AVE STE 301
VANCOUVER, WA 98664
Surgery
505 NE 87TH AVE STE 301
VANCOUVER, WA 98664
Surgery
505 NE 87TH AVE STE 301
VANCOUVER, WA 98664
Physician Assistant
505 NE 87TH AVE STE 301
VANCOUVER, WA 98664
Internal Medicine (Gastroenterology)
505 NE 87TH AVE STE 301
VANCOUVER, WA 98664
Physician Assistant
505 NE 87TH AVE STE 301
VANCOUVER, WA 98664
Internal Medicine (Gastroenterology)
505 NE 87TH AVE STE 301
VANCOUVER, WA 98664
Physician Assistant
505 NE 87TH AVE STE 301
VANCOUVER, WA 98664
Nurse Practitioner (Family)
505 NE 87TH AVE STE 301
VANCOUVER, WA 98664
Physician Assistant
505 NE 87TH AVE STE 301
VANCOUVER, WA 98664
Nurse Practitioner (Family)
505 NE 87TH AVE STE 301
VANCOUVER, WA 98664
Surgery
505 NE 87TH AVE STE 301
VANCOUVER, WA 98664

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1417319922, enumerated as an "individual" on March 23, 2016.

The provider is located at 505 NE 87TH AVE STE 301 VANCOUVER, WA 98664 and the phone number is (360) 514-1854.

Surgery with taxonomy code 2086S0127X and a focus in Trauma Surgery.

The provider might be accepting Accepts: BridgeSpan Health Company, Kaiser Permanente, Moda. Please consult your insurance carrier or call the provider to verify.

Nicholas Duletzke is affiliated with: PEACEHEALTH SOUTHWEST MEDICAL CENTER.