| Derek O Plotz, CRNA | |
|
700 S Park St, Madison, WI 53715-1830 | |
| (608) 251-6100 | |
| (608) 258-5222 |
| Full Name | Derek O Plotz |
|---|---|
| Gender | Male |
| Speciality | Certified Registered Nurse Anesthetist (crna) |
| Experience | 7 Years |
| Location | 700 S Park St, Madison, Wisconsin |
| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1659834554 | NPI | - | NPPES |
| 1659834554 | Medicaid | WI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 367500000X | Nurse Anesthetist, Certified Registered | 202208560CRNA-PP (Oregon) | Primary |
| 367500000X | Nurse Anesthetist, Certified Registered | 193884 (Wisconsin) | Secondary |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Oregon Pain Management Llc | 4183902695 | 4 |
| Hospitalist Medicine Physicians Of Washington - Tcs | 6800240102 | 197 |
| Entity Name | Kaiser Foundation Health Plan of the Northwest |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1184786527 PECOS PAC ID: 5799688230 Enrollment ID: O20040130000799 |
| Entity Name | Oregon Pain Management LLC |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1679936579 PECOS PAC ID: 4183902695 Enrollment ID: O20161102002967 |
| Entity Name | Hospitalist Medicine Physicians of Washington - Tcs |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1649816380 PECOS PAC ID: 6800240102 Enrollment ID: O20230920001616 |
| Mailing Address | Practice Location Address |
|---|---|
| Derek O Plotz, CRNA 500 Ne Multnomah St Ste 100, Portland, OR 97232-2031 Ph: (800) 813-2000 | Derek O Plotz, CRNA 700 S Park St, Madison, WI 53715-1830 Ph: (608) 251-6100 |
Justin Allen Lehrke, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 700 S Park St, Madison, WI 53715 Phone: 608-251-6100 Fax: 608-258-5222 |
Ashton Hope Mieritz, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 600 Highland Ave, Madison, WI 53792 Phone: 608-263-8100 |
Emily Christina Gilbertson, APRN, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 5113 Milwaukee St, Madison, WI 53714 Phone: 218-349-0493 |
Douglas J Konkol, CRNA Nurse Anesthetist - CR Medicare: Not Enrolled in Medicare Practice Location: 700 S Park St, St Marys Hospital Dean Medical Center, Madison, WI 53715 Phone: 608-258-6975 Fax: 608-258-5222 |
Carlos Anthony Anani, Nurse Anesthetist - CR Medicare: May Accept Medicare Assignments Practice Location: 600 Highland Ave, Madison, WI 53792 Phone: 608-263-8100 |
Alyssa Ct Tesar, CRNA Nurse Anesthetist - CR Medicare: Not Enrolled in Medicare Practice Location: 700 S Park St, Madison, WI 53715 Phone: 608-251-6100 |
Rebecca Ann Konkol, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 600 Highland Ave, Madison, WI 53792 Phone: 608-263-8100 Fax: 608-263-0575 |