DR. SETH MARK THALER MD
NPI 1609859602
Internal Medicine - Nephrology in Olympia, WA
NPI Status: Active since November 22, 2005
Contact Information
3525 ENSIGN RD NE
SUITE K
OLYMPIA, WA
ZIP 98506
Phone: (360) 413-8121
Fax: (360) 413-8865
- Individual
- Male
- Years of Experience 39
- Internal Medicine
- Nephrology
- Accepts Insurance
- Accepts Medicare Approved Payment
- PECOS Enrolled
- Medicare Quality Reporting
About SETH THALER
This page provides the complete NPI Profile along with additional information for Seth Thaler, an internist established in Olympia, Washington with a medical specialization in Internal Medicine, focusing in nephrology and more than 39 years of experience. He graduated from New York Medical College in 1987. The healthcare provider is registered in the NPI registry with number 1609859602 assigned on November 2005. The practitioner's primary taxonomy code is 207RN0300X with license number MD00036388 (WA). The provider is registered as an individual and his NPI record was last updated 2 years ago.
- NPI
- 1609859602
- Provider Name
- DR. SETH MARK THALER MD
- Gender
- Male
- Entity Type
- Individual
- Location Address
- 3525 ENSIGN RD NE SUITE K OLYMPIA, WA 98506
- Location Phone
- (360) 413-8121
- Location Fax
- (360) 413-8865
- Mailing Address
- 3525 ENSIGN RD NE SUITE K OLYMPIA, WA 98506
- Mailing Phone
- (360) 413-8121
- Mailing Fax
- (360) 413-8865
- Medical School Name
- NEW YORK MEDICAL COLLEGE
- Graduation Year
- 1987
- Is Sole Proprietor?
- No
- Enumeration Date
- 11-22-2005
- Last Update Date
- 10-21-2024
- Code Navigator
An internist like Seth Thaler is a physician who has completed an internal medicine residency and is board-certified or board-eligible in an internist specialty. Internists are trained to care for adults of all ages for many different medical conditions. An internist typically monitors chronic physical conditions, identifies acute diseases, provides family planning, provides counseling about wellness and disease prevention, etc.
Location Map
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
Internal Medicine Nephrology
- Taxonomy Code
- 207RN0300X
- Type
- Allopathic & Osteopathic Physicians
- License No.
- MD00036388
- License State
- WA
- Taxonomy Description
- An internist who treats disorders of the kidney, high blood pressure, fluid and mineral balance and dialysis of body wastes when the kidneys do not function. This specialist consults with surgeons about kidney transplantation.
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
- Core Bronze HSA 10600 - EPO
- Core Bronze HSA 7500 - EPO
- Core Bronze HSA 8300 - EPO
- Core Gold 1500 - EPO
- Core Gold 3000 - EPO
- Core Silver 3500 - EPO
- Core Silver 4500 - EPO
- Core Silver 5000 - EPO
- Core Silver 7500 - EPO
- Core Standard Expanded Bronze HSA - EPO
- Core Standard Gold - EPO
- Core Standard Silver - EPO
- PacificSource Oregon Standard Bronze HSA Plan Core - EPO
- PacificSource Oregon Standard Gold Plan Core - EPO
- PacificSource Oregon Standard Silver Plan Core - 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
- 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
- Providence Oregon Standard Silver Plan - Signature Network - EPO
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
Additional Identifiers
The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.
| Identifier | Type / Code | Identifier State | Identifier Issuer |
|---|---|---|---|
| 8228181 | MEDICAID (05) | WA |
Medicare Participation & PECOS Enrollment Status
Seth Thaler 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.
Seth Thaler 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: 2264565431
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: I20100809000955
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
Provider Referred Orders for Durable Medical Equipment, Devices & Supplies
The following list reflects the services, supplies or durable medical equipment ordered by this provider to a DME supplier on behalf of patients. The information below is derived from Medicare claims data and reflects the BETOS category, HCPCS code information and the number times each service was submitted under the Medicare fee-for-service program.
Unknown
Treatment-Treatment - Miscellaneous (RX029N)
Tacrolimus, immediate release, oral, 1 mg (HCPCS:J7507)
12 DME suppliers used 121 Medicare Claims 7581 Services Paid
Treatment-Treatment - Miscellaneous (RX029N)
Prednisone, immediate release or delayed release, oral, 1 mg (HCPCS:J7512)
4 DME suppliers used 36 Medicare Claims 4880 Services Paid
Treatment-Treatment - Miscellaneous (RX029N)
Mycophenolate mofetil, oral, 250 mg (HCPCS:J7517)
7 DME suppliers used 34 Medicare Claims 4320 Services Paid
Treatment-Treatment - Miscellaneous (RX029N)
Mycophenolic acid, oral, 180 mg (HCPCS:J7518)
4 DME suppliers used 35 Medicare Claims 4800 Services Paid
Treatment-Chemotherapy (RH012N)
Pharmacy supply fee for oral anti-cancer, oral anti-emetic or immunosuppressive drug(s); for the first prescription in a 30-day period (HCPCS:Q0511)
16 DME suppliers used 100 Medicare Claims 100 Services Paid
Treatment-Chemotherapy (RH012N)
Pharmacy supply fee for oral anti-cancer, oral anti-emetic or immunosuppressive drug(s); for a subsequent prescription in a 30-day period (HCPCS:Q0512)
13 DME suppliers used 135 Medicare Claims 148 Services Paid
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.
Dialysis services, 1 physician visit per month (20 years or older)
Dialysis services, 2-3 physician visits per month (20 years or older)
Dialysis services, 4 or more physician visits per month (20 years or older)
Established patient office or other outpatient visit, 30-39 minutes
Follow-up hospital inpatient care per day, typically 25 minutes
Follow-up hospital inpatient care per day, typically 35 minutes
Hemodialysis procedure with physician evaluation
Home dialysis services per month (20 years or older)
Injection of drug or substance under skin or into muscle
Injection, darbepoetin alfa, 1 microgram (non-esrd use)
New patient office or other outpatient visit, 45-59 minutes
Dialysis is a treatment that filters and purifies your blood using a machine. It helps keep your fluids and electrolytes in balance when the kidneys can’t do their job. A physician visit once a month ensures your treatment is working effectively and adjusts it if necessary. This service is available for individuals aged 20 years and older.
This service was performed 71 times for 29 patientsDialysis is a treatment that performs the function of healthy kidneys if they're not working properly. It removes waste and excess fluid from your blood. 2-3 physician visits per month are recommended for monitoring your health and adjusting your treatment as needed. This service is available for those aged 20 years and older.
This service was performed 123 times for 32 patientsDialysis is a treatment that filters and purifies your blood using a machine. It helps keep your fluids and electrolytes in balance when the kidneys can't do their job. This service includes 4 or more visits per month with a physician to monitor your health and adjust your treatment as needed.
This service was performed 127 times for 23 patientsThis is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.
This service was performed 268 times for 124 patientsFollow-up hospital inpatient care involves daily check-ups while you're admitted in the hospital. Typically, a healthcare provider spends about 25 minutes each day reviewing your condition, adjusting treatment if needed, and answering any questions you might have.
This service was performed 58 times for 29 patientsFollow-up hospital inpatient care per day typically involves a 35-minute check-up by your healthcare provider. This service includes monitoring your health progress, adjusting your treatment plan if needed, and answering any questions you may have about your condition or care.
This service was performed 93 times for 31 patientsHemodialysis is a treatment that uses a machine to filter waste and excess fluid from your blood when your kidneys can't. A physician checks your health before, during, and after the procedure to ensure it's working effectively for you.
This service was performed 34 times for 17 patientsHome dialysis services provide kidney treatment for patients aged 20 or older right in their own homes. This service includes necessary equipment, supplies, and support for performing dialysis. It's a convenient option that allows patients to maintain their daily routines while receiving essential care.
This service was performed 55 times for 11 patientsThis procedure involves administering medication directly under the skin or into a muscle. A small needle is used to inject the drug, allowing it to be absorbed quickly into the bloodstream. It's a common method for delivering a variety of medications.
This service was performed 19 times for 12 patientsDarbepoetin alfa injection is a medication used to treat anemia (low red blood cell count) often caused by chronic kidney disease or chemotherapy. It works by stimulating your body to produce more red blood cells, helping to increase your energy and well-being.
This service was performed 1,350 times for 12 patientsThis is a first-time office or outpatient visit lasting between 45-59 minutes. The healthcare provider evaluates your health, discusses your medical history, and may suggest further tests or treatments. It's an opportunity to ask questions and understand your health better.
This service was performed 19 times for 19 patientsPhysician Visit Costs
The typical physician office visit costs for Medicare beneficiaries in this area are: $32.74 for a new patient copayment and $25.19 for an established patient copayment.
The pricing information below displays the copayment minimum, maximum and average amount that patients under Medicare are charged when visiting this provider as a new or established patient. Please keep in mind that these prices are just for reference purposes, and the actual prices charged by the provider might be different.
For patients covered under private health plans the prices below are also useful as healthcare pricing for private insurance is usually established as a function of Medicare prices. Private insurance covered patients should check their individual plans to determine the exact pricing.
The prices below reflect the costs for new and established patients in the 98506 ZIP code area.
New Patients Visit Costs *
The most utilized procedure code for new patients office visits is 99204
- Average New Patient Price $130.99
- Minimum New Patient Price $57.27
- Maximum New Patient Price $172.8
- Average New Patient Copayment $32.74
- Minimum New Patient Copayment $14.31
- Maximum New Patient Copayment $43.2
Established Patients Visit Costs *
The most utilized procedure code for established patients office visits is 99214
- Average Established Patient Price $100.78
- Minimum Established Patient Price $18.56
- Maximum Established Patient Price $141.11
- Average Established Patient Copayment $25.19
- Minimum Established Patient Copayment $4.64
- Maximum Established Patient Copayment $35.27
* The physician office visit costs information is generated by statistical analysis of similar providers in the same geographical area. The pricing information above IS NOT the amount charged by this provider.
Quality Reporting
The provider participated in CMS Quality Payment Program. The Quality Payment Program aims to improve population health, reduce costs and improve the care received by Medicare beneficiaries. The following quality measures meet Medicare's statistical reporting standards. Not all providers report the same information, because not all providers give the same services to patients. The quality information is just a snapshot of some the care providers give to their patients. Reporting more or less information is not a reflection of quality.
| Quality Measure | Performance | Number of Patients |
|---|---|---|
| Care coordination agreements that promote improvements in patient tracking across settings | Yes | N/A |
| Establish effective care coordination and active referral management that could include one or more of the following: Establish care coordination agreements with frequently used consultants that set expectations for documented flow of information and MIPS eligible clinician or MIPS eligible clinician group expectations between settings. Provide patients with information that sets their expectations consistently with the care coordination agreements; Track patients referred to specialist through the entire process; and/or Systematically integrate information from referrals into the plan of care. | ||
| Documentation of Current Medications in the Medical Record | 100% | 876 |
| Percentage of visits for patients aged 18 years and older for which the eligible professional or eligible clinician attests to documenting a list of current medications using all immediate resources available on the date of the encounter. This list must include ALL known prescriptions, over-the-counters, herbals, and vitamin/mineral/dietary (nutritional) supplements AND must contain the medications' name, dosage, frequency and route of administration | ||
| Engagement of New Medicaid Patients and Follow-up | Yes | N/A |
| Seeing new and follow-up Medicaid patients in a timely manner, including individuals dually eligible for Medicaid and Medicare. A timely manner is defined as within 10 business days for this activity. | ||
| e-Prescribing | 93% | 1759 |
| At least one permissible prescription written by the MIPS eligible clinician is queried for a drug formulary and transmitted electronically using certified EHR technology. | ||
| Health Information Exchange | 79% | 33 |
| The MIPS eligible clinician that transitions or refers their patient to another setting of care or health care clinician (1) uses CEHRT to create a summary of care record; and (2) electronically transmits such summary to a receiving health care clinician for at least one transition of care or referral. | ||
| Medication Reconciliation | 98% | 944 |
| The MIPS eligible clinician performs medication reconciliation for at least one transition of care in which the patient is transitioned into the care of the MIPS eligible clinician. | ||
| One-Time Screening for Hepatitis C Virus (HCV) for Patients at Risk | 55% | 111 |
| Percentage of patients aged 18 years and older with one or more of the following: a history of injection drug use, receipt of a blood transfusion prior to 1992, receiving maintenance hemodialysis, OR birthdate in the years 1945-1965 who received one-time screening for hepatitis C virus (HCV) infection | ||
| Patient-Specific Education | 99% | 450 |
| The MIPS eligible clinician must use clinically relevant information from CEHRT to identify patient-specific educational resources and provide access to those materials to at least one unique patient seen by the MIPS eligible clinician. | ||
| Provide Patient Access | 49% | 450 |
| At least one patient seen by the MIPS eligible clinician during the performance period is provided timely access to view online, download, and transmit to a third party their health information subject to the MIPS eligible clinician's discretion to withhold certain information. | ||
| Secure Messaging | 6% | 450 |
| For at least one unique patient seen by the MIPS eligible clinician during the performance period, a secure message was sent using the electronic messaging function of CEHRT to the patient (or the patient-authorized representative), or in response to a secure message sent by the patient (or the patient-authorized representative) during the performance period. | ||
| Security Risk Analysis | Yes | N/A |
| Conduct or review a security risk analysis in accordance with the requirements in 45 CFR 164.308(a)(1), including addressing the security (to include encryption) of ePHI data created or maintained by certified EHR technology in accordance with requirements in 45 CFR164.312(a)(2)(iv) and 45 CFR 164.306(d)(3), and implement security updates as necessary and correct identified security deficiencies as part of the MIPS eligible clinician's risk management process. | ||
| Statin Therapy for the Prevention and Treatment of Cardiovascular Disease | 93% | 314 |
| Percentage of the following patients - all considered at high risk of cardiovascular events - who were prescribed or were on statin therapy during the measurement period: - Adults aged >= 21 years who were previously diagnosed with or currently have an active diagnosis of clinical atherosclerotic cardiovascular disease (ASCVD); OR - Adults aged >=21 years who have ever had a fasting or direct low-density lipoprotein cholesterol (LDL-C) level >= 190 mg/dL; OR - Adults aged 40-75 years with a diagnosis of diabetes with a fasting or direct LDL-C level of 70-189 mg/dL | ||
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. Seth Thaler is affiliated with the following medical facilities:
| Hospital Name | Address | Phone | Hospital Type | Overall Rating |
|---|---|---|---|---|
| PROVIDENCE ST PETER HOSPITAL | 413 LILLY ROAD NE OLYMPIA, WA 98506 | (360) 491-9480 | Acute Care Hospitals | |
| TACOMA GENERAL ALLENMORE HOSPITAL | 315 S MLK JR WAY TACOMA, WA 98405 | (253) 403-1000 | Acute Care Hospitals | |
| MASON GENERAL HOSPITAL & FAMILY OF CLINICS | 901 MT VIEW DRIVE SHELTON, WA 98584 | (360) 426-1611 | Critical Access Hospitals |
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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 1609859602, 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.
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.
Step 2: Add all digits plus the NPI constant
Add the transformed values, the unchanged digits, and the constant 24.
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.
Other Providers at the Same Location
The following 20 providers are registered at the same or a nearby location.
OLYMPIA, WA 98506
OLYMPIA, WA 98506
OLYMPIA, WA 98506
OLYMPIA, WA 98506
OLYMPIA, WA 98506
OLY, WA 98506
OLYMPIA, WA 98506
OLYMPIA, WA 98506
OLYMPIA, WA 98506
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1609859602, enumerated as an "individual" on November 22, 2005.
The provider is located at 3525 ENSIGN RD NE SUITE K OLYMPIA, WA 98506 and the phone number is (360) 413-8121.
Internal Medicine with taxonomy code 207RN0300X and a focus in Nephrology.
The provider might be accepting Accepts: PacificSource Health Plans, Premera Blue Cross. Please consult your insurance carrier or call the provider to verify.
Seth Thaler is affiliated with: PROVIDENCE ST PETER HOSPITAL, TACOMA GENERAL ALLENMORE HOSPITAL and MASON GENERAL HOSPITAL & FAMILY OF CLINICS.
