Mark David Derleth, M.D.

Primary specialty

Gastroenterology PhysicianTaxonomy code 207RG0100X

License

MD 60022504 Issued in WA

Practice address

1959 NE Pacific St
Box 356424
Seattle, WA 98195-6424

Phone

(206) 598-4377

NPI assigned

Aug 23, 2006

Last updated

Mar 18, 2014By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in WA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

GastroenterologyAlso: Internal Medicine

Education

Boston University School of Medicine, 2006

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

The Association of University PhysiciansGroup PAC ID 0446162697, 3,484 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• University of Washington Medical Ctr Hospital, Seattle, WA, CCN 500008

Merit-based Incentive Payment System (MIPS)

Final score

93.85 of 100Reported as apm

Quality

74.6

Promoting interoperability

100

Improvement activities

40

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: mderleth81935@direct.ehre.uwmedicine.org

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.

• The Association of University Physicians

  dba University of Washington Physicians

  • Anesthesiology Physician
  • Seattle, WA
  • NPI 1023041159
  Medicare reassignment Care Compare group NPD
• University of Washington

  dba University of Washington Medical Center

  • General Acute Care Hospital
  • Seattle, WA
  • NPI 1326002049
  Medicare reassignment NPD
• University of Washington

  dba University of Washington Medical Center Ambulatory

  • Community/Retail Pharmacy
  • Seattle, WA
  • NPI 1013950336
  NPD

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

• University of Washington

  dba University of Washington Medical Center

  • General Acute Care Hospital
  • Seattle, WA
  • NPI 1326002049
  Care Compare affiliation

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

{
    "created_epoch": "1156291200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1395100800000",
    "number": "1356457063",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1959 NE PACIFIC ST",
            "address_2": "BOX 356424",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981956424"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1959 NE PACIFIC ST",
            "address_2": "BOX 356424",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981956424",
            "telephone_number": "206-598-4377"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DERLETH",
        "first_name": "MARK",
        "middle_name": "DAVID",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-23",
        "last_updated": "2014-03-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "WA",
            "license": "MD 60022504",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Samson S Derebe, DDS
• Tatiana Deriugin, M.D.
• Taryn G Derke
• Elena Josephine Derkits, M.D.
• Andrew J Derksen-Schrock, MD
• Derman PLLC (Nilufer Norsworthy, M.D)
• Dermatology Associates of Seattle PS (Dermatology Associates of Seattle)
• Dermatology Associates PLLC
• Annalie Virginia Dern, LMT
• Rachael Dern, LMP

• Gastroenterology Physician in Seattle, WA
• Providers in Seattle, WA by specialty
• Gastroenterology Physician in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.