NPIMap

Individual provider Active NPI

Jeffrey S Danetz, MD

  • Surgery Physician
  • Owensboro, KY
National Provider Identifier
1215993209
Registry record updated Nov 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
47741 Issued in KY
Practice address
1325 Triplett St
Owensboro, KY 42303-3163
Phone
(270) 688-4325
Fax
(270) 687-4322
NPI assigned
Apr 26, 2006
Last updated
Nov 19, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 19, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 47741 KY Primary
Surgery Physician 208600000X TP082 KY
Surgery Physician 208600000X ME93263 FL
Vascular Surgery Physician 2086S0129X TP082 KY

Addresses

Primary practice location

1325 Triplett St
Owensboro, KY 42303-3163

Mailing address

PO Box 23229
Owensboro, KY 42304-3229
Phone (270) 688-1330

Other practice location 1

1307 N Main St
Beaver Dam, KY 42320-8957
Phone (270) 274-5601

Other identifiers 2

IdentifierTypeStateIssuer
16079OtherFLBCBS
272931800MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20141111000319 KY Practitioner - General SurgeryPractitioner - Vascular Surgery 2365414018 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
Rutgers R W Johnson Medical School (Cam/New Bruns/Pisc), 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Owensboro Health, IncGroup PAC ID 0547154650, shared by 9 NPIs, 179 clinicians

Practice addresses (Care Compare)

1006 Ford Ave
Owensboro, KY 42301-4677
Phone (270) 688-4845

1325 Triplett St
Owensboro, KY 42303-3163

2211 Mayfair Dr
Owensboro, KY 42301-4569

PO Box
Suite 23229
Owensboro, KY 42304-3229

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue872
Removal of nail tissue1-10
Removal or shaving of skin growth1-10
Skin biopsy1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Owensboro Health Medical Group Inc Surgery Current Accepting new patients
Owensboro Health Medical Group, Inc Surgery CurrentSince Oct 20, 2014 Accepting new patients
Owensboro Health Medical Group Inc CurrentSince Oct 20, 2014 Accepting new patients
Vascular Surgical Associates, PC Vascular Surgery Past Accepting new patients
Owensboro Health Medical Group, Inc Past Accepting new patients

Locations

1307 N Main St
Beaver Dam, KY 42320
Phone (270) 274-5601

1325 Triplett St
Owensboro, KY 42303
Phone (270) 686-8500

1325 Triplett St
#B
Owensboro, KY 42303
Phone (270) 688-4235

2211 Mayfair Dr
Ste 101
Owensboro, KY 42301
Phone (270) 688-1352

2211 Mayfair Dr
Ste 102
Owensboro, KY 42301
Phone (270) 688-1351

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 5

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1146009600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731974400000",
    "number": "1215993209",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 23229",
            "city": "OWENSBORO",
            "state": "KY",
            "postal_code": "423043229",
            "telephone_number": "270-688-1330",
            "fax_number": "270-688-1338"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1325 TRIPLETT ST",
            "city": "OWENSBORO",
            "state": "KY",
            "postal_code": "423033163",
            "telephone_number": "270-688-4325",
            "fax_number": "270-687-4322"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1307 N Main St",
            "address_purpose": "LOCATION",
            "city": "Beaver Dam",
            "state": "KY",
            "postal_code": "423208957",
            "country_code": "US",
            "telephone_number": "270-274-5601",
            "fax_number": "270-274-5612",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DANETZ",
        "first_name": "JEFFREY",
        "middle_name": "S",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-26",
        "last_updated": "2024-11-19",
        "certification_date": "2024-11-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "KY",
            "license": "47741",
            "primary": true
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "KY",
            "license": "TP082",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "FL",
            "license": "ME93263",
            "primary": false
        },
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "KY",
            "license": "TP082",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "16079",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "272931800",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Owensboro, KY

Sources for this page

Verify at the official NPI Registry.