1. Home
  2. Directory
  3. Washington
  4. Olympia
  5. Orthopaedic Surgery
  6. NPI Profile

DEREK GEORGE DOMBROSKI MD
NPI 1992865869
Orthopaedic Surgery - Orthopaedic Trauma in Olympia, WA

Active since December 11, 2006PECOS EnrolledAccepts Medicare Assignment
75.27/100
CMS Quality Rating
615 LILLY RD NE STE 100, OLYMPIA, WA 98506(360) 491-4211(360) 493-0407 Get Directions Write a Review

NPPES record last updated: March 17, 2025. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Mar 17, 2025, Dec 20, 2022, Nov 1, 2018 and 2 more (5 updates tracked since 2018).

About Derek George Dombroski Md NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DEREK GEORGE DOMBROSKI MD (NPI 1992865869) is an individual orthopaedic trauma provider in Olympia, Washington, licensed in Washington (MD61552497) and active in the NPI registry since December 2006. He is enrolled in Medicare PECOS, is affiliated with Kona Community Hospital, and is a graduate of University Of Texas Medical School At San Antonio (2005).

NPPES Registry Identity

NPI1992865869
Entity TypeIndividualMale
Primary Taxonomy207XX0801X
Provider Legal NameDEREK GEORGE DOMBROSKICredential: MD
Location Address615 LILLY RD NE STE 100Olympia, WA 98506-5117
Mailing Address3382 Waialae AveHonolulu, HI 96816-2637 · (808) 548-7033
Phone(360) 491-4211
Fax(360) 493-0407
Sole ProprietorNo
Medical School CMSUniversity Of Texas Medical School At San AntonioGraduated 2005
Enumeration DateDecember 11, 2006
Last NPPES UpdateMarch 17, 20255 updates tracked since enumeration
NPPES CertifiedMarch 17, 2025
✔ NPI 1992865869 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyOrthopaedic Surgery · Orthopaedic TraumaAllopathic & Osteopathic Physicians
Taxonomy Code207XX0801X
License✔ Licensed in WA · MD61552497
Definition
Recognized by several state medical boards as a fellowship subspecialty program of orthopaedic surgery, orthopaedic trauma surgeons deal with the evaluation and management of acute orthopaedic injuries, evaluation and treatment of post-traumatic deformities and nonunions, acute and delayed reconstruction of pelvic and acetabular fractures, as well as osteotomy in the adult hip for treatment of hip arthritis.
615 LILLY RD NE STE 100, Olympia, WA 98506
Open in Google Maps ↗

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Arizona Complete Health, Ambetter from Arkansas Health & Wellness, Ambetter from Louisiana Healthcare Connections and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Derek George Dombroski Md is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID2466614326
PECOS Enrollment IDI20120510000423, I20181114002449
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignments

3

Medicare enrollment records show Derek Dombroski reassigns Medicare billing to 3 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Texas Health Physicians Group
1,665 mi
Internal Medicine
1301 PENNSYLVANIA AVE
Fort Worth, TX 76104
  • Reassigned Medicare billing, Texas enrollment
  • 1,639 clinicians in this Medicare group
NPI 1174573596 (214) 860-6300
Eastern Maine Medical Center
2,559 mi
General Acute Care Hospital
489 STATE ST
Bangor, ME 04401
  • Reassigned Medicare billing, Maine enrollment
  • 788 clinicians in this Medicare group
NPI 1790789147 (207) 973-7000
Alii Health Center
2,616 mi
Multi-Specialty
78-6831 ALII DR STE 328
Kailua Kona, HI 96740
  • Reassigned Medicare billing, Hawaii enrollment
  • 60 clinicians in this Medicare group
NPI 1285107698 (808) 747-8321

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Areas of Expertise CMS Part B claims 9

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213
This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.
91 services61 patients
Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes 99222
Initial hospital inpatient care is a service where a healthcare provider spends about 50 minutes per day overseeing your care while you're admitted in the hospital. This includes reviewing your health status, planning your treatment, and ensuring your safety and comfort.
58 services58 patients
Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes 99223
Initial hospital inpatient care per day, typically 70 minutes, refers to the daily medical service provided to patients admitted to the hospital. This includes a comprehensive evaluation, diagnosis, treatment plan, and monitoring of your health condition. It ensures your well-being during your hospital stay.
39 services39 patients
X-ray of thigh bone, minimum 2 views 73552
An X-ray of the thigh bone is a non-invasive imaging test. It involves passing a small amount of radiation through the thigh to produce images of the bone structure. At least two different angles are captured for a comprehensive view. This helps detect fractures, infections, or other abnormalities.
29 services17 patients
X-ray of knee, 3 views 73562
An X-ray of the knee, 3 views, is a non-invasive imaging test. It uses a small amount of radiation to produce images of the knee from three different angles. This helps medical professionals to diagnose and monitor conditions like arthritis, fractures, or infections. The process is quick and painless.
25 services11 patients
X-ray of hip, 2-3 views 73502
An X-ray of the hip with 2-3 views is a non-invasive imaging test. It uses a small amount of radiation to produce pictures of the hip joint. These images help in diagnosing conditions like fractures, arthritis, or other abnormalities. The process is quick and painless.
20 services16 patients

Hospital Affiliations CMS Care Compare 3

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Kona Community Hospital

Acute Care Hospitals · Kealakekua, HI
1/5 CMS rating
OwnershipGovernment - State
CMS Certification Number120019
Location79-1019 Haukapila StreetKealakekua, HI 96750 · Hawaii County
Emergency services Birthing friendly

Northern Light Eastern Maine Medical Center

Acute Care Hospitals · Bangor, ME
4/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number200033
Location489 State StreetBangor, ME 04401 · Penobscot County
Emergency services Birthing friendly

Texas Health Harris Methodist Hospital Fort Worth

Acute Care Hospitals · Fort Worth, TX
3/5 CMS rating
OwnershipVoluntary non-profit - Church
CMS Certification Number450135
Location1301 Pennsylvania AvenueFort Worth, TX 76104 · Tarrant County
Emergency services Birthing friendly

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

75.27/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality68.07
Promoting Interoperability100
Improvement Activities40
Cost49.5

Other Providers at the Same Location NPPES 12

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

CHRISTOPHER THOMAS SPIKES PA-C
Physician Assistant (Surgical)
615 LILLY RD NE STE 100
OLYMPIA, WA 98506
Thurston County (360) 491-4211
RICHARD JOSEPH LAMOUR MD
Orthopaedic Surgery (Foot and Ankle Surgery)
615 LILLY RD NE STE 100
OLYMPIA, WA 98506
Thurston County (360) 491-8439
DR. CHRISTINA HAJEWSKI M.D.
Orthopaedic Surgery (Orthopaedic Surgery of the Spine)
615 LILLY RD NE STE 100
OLYMPIA, WA 98506
Thurston County (360) 491-4211
MICHELLE MCGINLEY ARNP
Nurse Practitioner
615 LILLY RD NE STE 100
OLYMPIA, WA 98506
Thurston County (360) 491-4211
PRESTON ERIC LOPEZ PA
Physician Assistant (Surgical)
615 LILLY RD NE STE 100
OLYMPIA, WA 98506
Thurston County (360) 491-4211
KENG MOUA PA-C
Physician Assistant
615 LILLY RD NE STE 100
OLYMPIA, WA 98506
Thurston County (360) 491-4211
DR. LOGAN BUSHNELL DO
Orthopaedic Surgery
615 LILLY RD NE STE 100
OLYMPIA, WA 98506
Thurston County (360) 491-4211
STEVEN JOHNS PA-C
Physician Assistant (Surgical)
615 LILLY RD NE STE 100
OLYMPIA, WA 98506
Thurston County (360) 491-4211

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Derek Dombroski's NPI number?

The NPI number for Derek Dombroski is 1992865869. It was assigned to this individual provider in the NPPES registry on December 11, 2006.

Where is Derek Dombroski located?

Derek Dombroski practices at 615 Lilly Rd NE Ste 100, Olympia, WA 98506. The listed phone number is (360) 491-4211.

What is Derek Dombroski's specialty?

The primary specialty registered for this NPI is Orthopaedic Surgery, specializing in Orthopaedic Trauma, with taxonomy code 207XX0801X.

Is Derek Dombroski enrolled in Medicare?

Yes. Derek Dombroski is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

Which organizations bill Medicare for Derek Dombroski's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Derek Dombroski reassigns Medicare benefits to 3 organizations: Texas Health Physicians Group (Fort Worth, TX), Eastern Maine Medical Center (Bangor, ME) and Alii Health Center (Kailua Kona, HI). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Derek Dombroski's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Derek Dombroski accept?

Health plans from Ambetter from Arizona Complete Health, Ambetter from Arkansas Health & Wellness, Ambetter from Louisiana Healthcare Connections, Ambetter from Superior HealthPlan and Ambetter of Oklahoma and 5 other insurers list Derek Dombroski as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

Is Derek Dombroski affiliated with any hospitals?

According to CMS data, Derek Dombroski is affiliated with Kona Community Hospital, Northern Light Eastern Maine Medical Center and Texas Health Harris Methodist Hospital Fort Worth.

When was this NPI record last updated?

The NPPES record for Derek Dombroski was last updated on March 17, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 19 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.