Jack L Deetjen, M.D.

Primary specialty

Orthopaedic Surgery PhysicianTaxonomy code 207X00000X

License

G4967 Issued in TX

Practice address

515 N King St
Suite 106
Seguin, TX 78155-4815

Phone

(830) 379-8371

Fax

(830) 379-8378

NPI assigned

May 5, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in TX

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

Orthopedic Surgery

Education

Baylor College of Medicine, 1983

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Guadalupe Regional Medical GroupGroup PAC ID 6800077694, 38 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Advanced Home Health Services Home health agency, Seguin, TX, CCN 677247
• Guadalupe Regional Medical Center Hospital, Seguin, TX, CCN 450104
• Memorial Hospital Hospital, Gonzales, TX, CCN 450235

Merit-based Incentive Payment System (MIPS)

Final score

8.17 of 100Reported as individual

Quality

0

Improvement activities

0

Cost

27.22

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/1438/brand/7/csg/201/fhir/r4
• Direct secure messaging: jack.deetjen.1@27064.direct.athenahealth.com
• FHIR API: https://api.platform.athenahealth.com/27064/brand/1/csg/1/fhir/r4

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.

• Guadalupe Regional Medical Group

  • Multi-Specialty Clinic/Center
  • Seguin, TX
  • NPI 1578873717
  Medicare reassignment Care Compare group NPD
• Jack L Deetjen MD PLLC

  • Orthopaedic Surgery Physician
  • Seguin, TX
  • NPI 1184134132
  Medicare reassignment
• Guadalupe Regional Medical Group

  • Urgent Care Clinic/Center
  • New Braunfels, TX
  • NPI 1114559432
  NPD
• Guadalupe County Hospital Board

  • Hospitalist Physician
  • Seguin, TX
  • NPI 1841512845
  NPD (past)
• Resolute Health Physicians Network Inc

  • Endocrinology, Diabetes & Metabolism Physician
  • New Braunfels, TX
  • NPI 1679869218
  NPD (past)

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

• Advanced HH, LLC

  • Home Health Agency
  • Seguin, TX
  • NPI 1598701716
  Care Compare affiliation
• Gonzales Healthcare Systems

  • Rural Acute Care Hospital
  • Gonzales, TX
  • NPI 1932108214
  Care Compare affiliation
• Guadalupe County Hospital Board

  • Nursing Care Agency
  • Seguin, TX
  • NPI 1487674727

  Hospital

  Care Compare affiliation
• Guadalupe County Hospital Board

  • General Acute Care Hospital
  • Seguin, TX
  • NPI 1720088123
  Care Compare affiliation
• Guadalupe County Hospital Board

  • General Acute Care Hospital
  • Seguin, TX
  • NPI 1780529966
  Care Compare affiliation

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

{
    "created_epoch": "1146787200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722470400000",
    "number": "1699723320",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "515 N KING ST",
            "address_2": "SUITE 106",
            "city": "SEGUIN",
            "state": "TX",
            "postal_code": "781554815",
            "telephone_number": "830-379-8371",
            "fax_number": "830-379-8378"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "515 N KING ST",
            "address_2": "SUITE 106",
            "city": "SEGUIN",
            "state": "TX",
            "postal_code": "781554815",
            "telephone_number": "830-379-8371",
            "fax_number": "830-379-8378"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEETJEN",
        "first_name": "JACK",
        "middle_name": "L",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-05-05",
        "last_updated": "2024-08-01",
        "certification_date": "2024-08-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "TX",
            "license": "G4967",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "00H38Y",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "033725501",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Angela Marie Davis, APRN, CPNP
• Daybreak, Inc.
• Daybreak, Inc.
• Dean L Zincone MD PA
• Lisa Marie Deboer, FNP
• Brittany Nicole Deremer, LPC
• Elizabeth Rae Diaz, LCSW
• Samantha Diaz, RN
• Katie Dickens, DDS
• Melissa Veronica Dorado

• Orthopaedic Surgery Physician in Seguin, TX
• Providers in Seguin, TX by specialty
• Orthopaedic Surgery Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 1, 2024; 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.