NPIMap

Individual provider Active NPI

Derek George Dombroski, MD

  • Orthopaedic Trauma Physician
  • Olympia, WA
National Provider Identifier
1992865869
Registry record updated Mar 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Trauma PhysicianTaxonomy code 207XX0801X
License
MD61552497 Issued in WA
Practice address
615 Lilly Rd NE Ste 100
Olympia, WA 98506-5117
Phone
(360) 491-4211
Fax
(360) 493-0407
NPI assigned
Dec 11, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Trauma Physician 207XX0801X MD61552497 WA Primary

Addresses

Primary practice location

615 Lilly Rd NE Ste 100
Olympia, WA 98506-5117

Mailing address

3382 Waialae Ave
Honolulu, HI 96816-2637
Phone (808) 548-7033

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX, HI2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20120510000423 TX Practitioner - Orthopedic Surgery 2466614326 Reassigns benefits to 1 organization
I20181114002449 HI Practitioner - Orthopedic Surgery 2466614326 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Orthopedic Surgery
Education
University of Texas Medical School at San Antonio, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Alii Health CenterGroup PAC ID 4486984549, 50 clinicians
Texas Health Physicians GroupGroup PAC ID 4385535954, 1,364 clinicians

Practice addresses (Care Compare)

78 -6831 Alii Dr
Suite 422
Kailua Kona, HI 96740-5402
Phone (808) 747-8321

800 5TH Ave
Suite 500
Fort Worth, TX 76104-7304
Phone (817) 878-5300

Hospital & facility affiliations

  • Kona Community Hospital Hospital, Kealakekua, HI, CCN 120019
  • Texas Health Harris Methodist Fort Worth Hospital, Fort Worth, TX, CCN 450135
  • Northern Light Eastern Maine Medical Center Hospital, Bangor, ME, CCN 200033

Merit-based Incentive Payment System (MIPS)

Final score
88.86 of 100Reported as group
Quality
75.41
Promoting interoperability
100
Improvement activities
40
Cost
87.45

Procedures performed for Medicare patients

ProcedureNumber of procedures
Hip replacement1-10
Lower limb (leg) arthroscopy (minimally invasive joint repair)1-10
Removal of tissue1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Ali'I Health Center CurrentSince Aug 22, 2025 Accepting new patients
Texas Health Physicians Group Current Accepting new patients
Texas Health Physicians Group CurrentSince Mar 1, 2012 Accepting new patients
Texas Health Physicians Group CurrentSince Mar 1, 2012 Accepting new patients
Queens North Hawaii Community Hospital Current Accepting new patients
Alii Health Center Past Accepting new patients
Alii Health Center PastSince Feb 14, 2021 Accepting new patients

Locations

78-6831 Alii Dr
Ste 422
Kailua Kona, HI 96740
Phone (808) 747-8321

1600 Hospital Pkwy
Bedford, TX 76022
Phone (817) 355-7803

4333 N Josey Ln
Ste 104
Carrollton, TX 75010
Phone (972) 394-4500

800 5th Ave
Ste 500
Ft Worth, TX 76104
Phone (817) 250-4280

341 Wheatfield Dr
Ste 100
Sunnyvale, TX 75182
Phone (972) 329-1996

Interoperability endpoints

  • Direct secure messaging: derek.dombroski@hawaiihie.medicity.net

Organizations & group practices 8

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.

Hospital & facility affiliations 3

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

NPI Registry JSON

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

{
    "created_epoch": "1165795200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1742169600000",
    "number": "1992865869",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3382 WAIALAE AVE",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968162637",
            "telephone_number": "808-548-7033"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "615 LILLY RD NE STE 100",
            "city": "OLYMPIA",
            "state": "WA",
            "postal_code": "985065117",
            "telephone_number": "360-491-4211",
            "fax_number": "360-493-0407"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOMBROSKI",
        "first_name": "DEREK",
        "middle_name": "GEORGE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-11",
        "last_updated": "2025-03-17",
        "certification_date": "2025-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207XX0801X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Orthopaedic Trauma",
            "state": "WA",
            "license": "MD61552497",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Olympia, WA

Sources for this page

Verify at the official NPI Registry.