Nicolaas Piet Deruyter, MD

Primary specialty

Ophthalmology PhysicianTaxonomy code 207W00000X

License

MD61507714 Issued in WA

Practice address

1750 112TH Ave NE Ste D050
Bellevue, WA 98004-3779

Phone

(206) 215-3850

Fax

(206) 215-3870

NPI assigned

Apr 9, 2018

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

Ophthalmology

Education

University of Washington School of Medicine, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Pacific Northwest Retina PLLCGroup PAC ID 8820494073, 19 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Swedish Medical Center Hospital, Seattle, WA, CCN 500027

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: nicolaas.deruyter.p16@direct.pnwr.nextgenshare.com
• FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/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.

• Pacific Northwest Retina PLLC

  • Retina Specialist (Ophthalmology) Physician
  • Bellevue, WA
  • NPI 1558940387
  Medicare reassignment Care Compare group NPD
• Proliance Surgeons Inc P S

  • Orthopaedic Surgery Physician
  • Renton, WA
  • NPI 1235091463
  NPD (past)
• The Retina Surgery Center LLC

  • Ambulatory Surgical Clinic/Center
  • Bellevue, WA
  • NPI 1457670648
  NPD (past)

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

• Swedish Health Services

  • General Acute Care Hospital
  • Seattle, WA
  • NPI 1306992151
  Care Compare affiliation

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

{
    "created_epoch": "1523232000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1770076800000",
    "number": "1972000602",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22232 17TH AVE SE STE 308",
            "city": "BOTHELL",
            "state": "WA",
            "postal_code": "980217425",
            "telephone_number": "425-296-3837",
            "fax_number": "206-215-3870"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1750 112TH AVE NE STE D050",
            "city": "BELLEVUE",
            "state": "WA",
            "postal_code": "980043779",
            "telephone_number": "206-215-3850",
            "fax_number": "206-215-3870"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1229 Madison St Ste 620",
            "address_purpose": "LOCATION",
            "city": "Seattle",
            "state": "WA",
            "postal_code": "981043304",
            "country_code": "US",
            "telephone_number": "206-215-3850",
            "fax_number": "206-215-3870",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DERUYTER",
        "first_name": "NICOLAAS",
        "middle_name": "PIET",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-04-09",
        "last_updated": "2026-02-03",
        "certification_date": "2026-02-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "WA",
            "license": "MD61507714",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tatjana Deretic, M.D.
• Dermatology Arts, PLLC
• Dermatopatholoty Northwest PLLC
• Jessica Laura Deroche, LMT
• Eric Derovanessian, D.D.S
• Arzu Dervish
• Vicki A Deshazo
• Aarti R Deshpande, M.D.
• Anna A Desimone, L.M.P.
• Bethany J. Desimone, ATC

• Ophthalmology Physician in Bellevue, WA
• Providers in Bellevue, WA by specialty
• Ophthalmology Physician in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 3, 2026; 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.