Dolf R Ichtertz, M.D.

Primary specialty

Orthopaedic Hand Surgery PhysicianTaxonomy code 207XS0106X

License

218344310 Issued in NE

Practice address

716 N Alpha St
Grand Island, NE 68803-4318

Phone

(308) 389-3312

Fax

(308) 389-3390

NPI assigned

Sep 27, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in NE

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 SurgeryAlso: Hand Surgery

Education

Baylor College of Medicine, 1981

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Practice addresses (Care Compare)

Hospital & facility affiliations

• Grand Island Regional Medical Center Hospital, Grand Island, NE, CCN 280139
• CHI Health St. Francis Hospital, Grand Island, NE, CCN 280023

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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.

• Nebraska Hand & Shoulder Institute PC

  • Orthopaedic Surgery Physician
  • Grand Island, NE
  • NPI 1508197435
  Medicare reassignment Authorized official

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

• Grand Island Regional Medical Center

  • General Acute Care Hospital
  • Grand Island, NE
  • NPI 1558910604
  Care Compare affiliation
• Saint Francis Medical Center

  • General Acute Care Hospital
  • Grand Island, NE
  • NPI 1982675955
  Care Compare affiliation

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

{
    "created_epoch": "1159315200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1952492845",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "716 N ALPHA ST",
            "city": "GRAND ISLAND",
            "state": "NE",
            "postal_code": "688034318",
            "telephone_number": "308-389-3312",
            "fax_number": "308-389-3390"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "716 N ALPHA ST",
            "city": "GRAND ISLAND",
            "state": "NE",
            "postal_code": "688034318",
            "telephone_number": "308-389-3312",
            "fax_number": "308-389-3390"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ICHTERTZ",
        "first_name": "DOLF",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-27",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207XS0106X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Hand Surgery",
            "state": "NE",
            "license": "218344310",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS PROVIDER ID",
            "identifier": "07250",
            "state": "NE"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "47082696900",
            "state": "NE"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE PROVIDER ID",
            "identifier": "200036906",
            "state": "NE"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Alexys Hurt
• Steven L Husen, M.D.
• Huskerland Hearing Center LLC
• Hy-Vee Inc
• Lexie Eva Ibal-Gonzalez
• Shayla Illingworth-Ferguson
• Elpidionestor Tabutol Iloreta, MD
• Linda Ingebretsen
• Donna Ingold
• Tonya Sue Ingram, LMHP

• Orthopaedic Hand Surgery Physician in Grand Island, NE
• Providers in Grand Island, NE by specialty
• Orthopaedic Hand Surgery Physician in Nebraska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; 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.