Jonathan S. Deitch, M.D.

Primary specialty

Vascular Surgery PhysicianTaxonomy code 2086S0129X

License

T3610 Issued in TX

Practice address

1325 Pennsylvania Ave Ste 680
Fort Worth, TX 76104-2133

Phone

(817) 250-4235

NPI assigned

Jan 3, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NY, TX2 enrollments

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 2

Specialty

Vascular Surgery

Education

New York Medical College, 1991

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Texas Health Physicians GroupGroup PAC ID 4385535954, 1,364 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Texas Health Harris Methodist Fort Worth Hospital, Fort Worth, TX, CCN 450135
• Texas Health Harris Methodist Hospital Cleburne Hospital, Cleburne, TX, CCN 450148

Merit-based Incentive Payment System (MIPS)

Final score

84.82 of 100Reported as individual

Quality

53.61

Promoting interoperability

100

Improvement activities

40

Cost

75.61

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jdeitch1829178@direct.texashealth.org

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

• Texas Health Physicians Group

  • Internal Medicine Physician
  • Fort Worth, TX
  • NPI 1174573596
  Medicare reassignment Care Compare group NPD
• North Shore-Lij Medical PC

  • Urology Physician
  • Great Neck, NY
  • NPI 1053688572
  Medicare reassignment NPD
• Texas Health Physicians Group

  • Sleep Disorder Diagnostic Clinic/Center
  • Fort Worth, TX
  • NPI 1114395969
  NPD
• Texas Health Physicians Group

  • Sleep Disorder Diagnostic Clinic/Center
  • Dallas, TX
  • NPI 1174992051
  NPD
• Physicians of University Hospital, PC

  • Geriatric Medicine (Internal Medicine) Physician
  • Staten Island, NY
  • NPI 1417901323
  NPD (past)
• TJH Medical Services, P.C.

  • Internal Medicine Physician
  • Jamaica, NY
  • NPI 1184670465
  NPD (past)
• University Physicians of Brooklyn, Inc

  • Anesthesiology Physician
  • Brooklyn, NY
  • NPI 1104878180
  NPD (past)
• University Physicians of Brooklyn, Inc.

  • Surgery Physician
  • Brooklyn, NY
  • NPI 1538116082

  Vascular Surgery

  NPD (past)
• Weill Medical College of Cornell

  • Surgery Physician
  • New York, NY
  • NPI 1669579017
  NPD (past)

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

• Texas Health Harris Methodist Hospital Cleburne

  • General Acute Care Hospital
  • Cleburne, TX
  • NPI 1396778064
  Care Compare affiliation
• Texas Health Harris Methodist Hospital Fort Worth

  • General Acute Care Hospital
  • Fort Worth, TX
  • NPI 1336172105
  Care Compare affiliation

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

{
    "created_epoch": "1136246400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1634688000000",
    "number": "1679551469",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1325 PENNSYLVANIA AVE STE 680",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761042133",
            "telephone_number": "817-250-4235"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1325 PENNSYLVANIA AVE STE 680",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761042133",
            "telephone_number": "817-250-4235"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEITCH",
        "first_name": "JONATHAN",
        "middle_name": "S.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-03",
        "last_updated": "2021-10-20",
        "certification_date": "2021-10-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "NY",
            "license": "194966-1",
            "primary": false
        },
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "TX",
            "license": "T3610",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01921764",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• John David Deetjen, PA-C
• Elizabeth Degrand, OTD, OTR
• Charis Degrate
• Dehaven Diagnostics, LLC
• Benjamin Michael Deheshi, MD
• Dejus LLC
• Jennifer D Del Angel, LCSW
• Katrina Camille Del Prado, RN
• Julie Kendall Delafield, LPC, LMFT ASSOCIATE
• Elizabeth Delaney

• Vascular Surgery Physician in Fort Worth, TX
• Providers in Fort Worth, TX by specialty
• Vascular Surgery Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 20, 2021; 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.