Dominic Lee Van Nielen, MD is a medicare enrolled "Orthopaedic Surgery" physician in Monroe, Washington. He went to Tulane University School Of Medicine and graduated in 2012 and has 14 years of diverse experience with area of expertise as Orthopedic Surgery. He is a member of the group practice Proliance Surgeons Inc P S and his current practice location is
19200 N Kelsey St, Monroe, Washington. You can reach out to his office (for appointments etc.) via phone at
(425) 339-2433.
Dominic Lee Van Nielen is licensed to practice in Washington (license number MD61002589) and he also participates in the medicare program. He
accepts medicare assignments (which means he accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and his NPI Number is 1184990590.
Physician's Profile
| Full Name | Dominic Lee Van Nielen |
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| Gender | Male |
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| Speciality | Orthopedic Surgery |
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| Experience | 14 Years |
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| Location | 19200 N Kelsey St, Monroe, Washington |
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| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
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Medical Education and Training:
- Dominic Lee Van Nielen attended and graduated from Tulane University School Of Medicine in 2012
NPI Data:
- NPI Number: 1184990590
- Provider Enumeration Date: 03/29/2012
- Last Update Date: 08/31/2023
Medicare PECOS Information:
- PECOS PAC ID: 5799083903
- Enrollment ID: I20230830002126
Medical Identifiers
Medical identifiers for Dominic Lee Van Nielen such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1184990590 | NPI | - | NPPES |
| 2249981 | Medicaid | WA | |
| 466835 | Other | WA | WA L&I |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 207X00000X | Orthopaedic Surgery | D94626 (Maryland) | Secondary |
| 207XS0114X | Orthopaedic Surgery - Adult Reconstructive Orthopaedic Surgery | MD61002589 (Washington) | Secondary |
| 207X00000X | Orthopaedic Surgery | MD61002589 (Washington) | Primary |
Medical Facilities Affiliation
Group Practice Association
| Group Practice Name | Group PECOS PAC ID | No. of Members |
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| Proliance Surgeons Inc P S | 8527972900 | 355 |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Dominic Lee Van Nielen allows following entities to bill medicare on his behalf.
| Entity Name | Proliance Surgeons Inc P S |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1023170313
PECOS PAC ID: 8527972900
Enrollment ID: O20031119000128 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Dominic Lee Van Nielen is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
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Dominic Lee Van Nielen, MD
1100 Pacific Ave Ste 300,
Everett, WA 98201-4261
Ph: (425) 339-2433 | Dominic Lee Van Nielen, MD
19200 N Kelsey St,
Monroe, WA 98272-1431
Ph: (425) 339-2433 |
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