Dominic Lee Van Nielen, MD is a medicare enrolled "Orthopaedic Surgery" physician in Monroe, Washington. 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 does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. 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 | Orthopaedic Surgery |
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Location | 19200 N Kelsey St, Monroe, Washington |
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Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
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 |
207X00000X | Orthopaedic Surgery | D94626 (Maryland) | Secondary |
207XS0114X | Orthopaedic Surgery - Adult Reconstructive Orthopaedic Surgery | MD61002589 (Washington) | Secondary |
207X00000X | Orthopaedic Surgery | MD61002589 (Washington) | Primary |
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 Ps |
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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 |
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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