DOMINIC LEE VAN NIELEN (M.D.) – Orthopaedic Surgery Physician, NPI 1184990590
Orthopaedic Surgery Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
1,916 ORTHOPEDIC SURGERY in FL
Provider Addresses for DOMINIC LEE VAN NIELEN (M.D.)
554 KEILY STREET
JACKSONVILLE, FL 32212
Phone:
Type: Mailing
1100 Pacific Ave Ste 300
Everett, WA 982014261
Phone: (425) 339-2433
Fax: (425) 339-8273
Type: Location
1100 PACIFIC AVE STE 300
EVERETT, WA 982014261
Phone: (425) 339-2433
Fax: (425) 339-8273
Type: Mailing
19200 N KELSEY ST
MONROE, WA 982721431
Phone: (425) 339-2433
Fax: (425) 339-8237
Type: Location
2401 W BELVEDERE AVE
BALTIMORE, MD 212155216
Phone: (410) 601-2663
Fax: (410) 601-8501
Type: Mailing
5401 OLD COURT RD
RANDALLSTOWN, MD 211335103
Phone: (410) 601-2663
Fax: (410) 601-8501
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 40 Open Payments records for all available years, with a total value of $12,374.
Total Amount is formed as General ($12,374) + Research ($0) + Ownership ($0) = $12,374.
Last reported payment date: 2024-10-26 • Largest payer in this snapshot: Smith+Nephew, Inc. ($9,559).
Total Amount
$12,374
General + Research + Ownership
Payments
40
Total payment records
General Amount
$12,374
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-10-26
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Smith+Nephew, Inc. | $9,559 |
| Stryker Corporation | $1,595 |
| DePuy Synthes Sales Inc. | $1,097 |
| Avanos Medical | $45 |
| Fidia Pharma USA Inc. | $27 |
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2023-08-30
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.
Enrollment records
1
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20230830002126 | I | Orthopedic Surgery | WA | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
Top Medicare procedures (2023) · refreshed 2026-05-27
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| J3301 | Injection, triamcinolone acetonide, not otherwise specified, 10 mg | 104 | 23 | $0 |
| 99204 | New patient office or other outpatient visit, 45-59 minutes | 34 | 34 | $0 |
| 73502 | X-ray of hip, 2-3 views | 31 | 25 | $0 |
| 20610 | Aspiration and/or injection of fluid from large joint | 30 | 26 | $0 |
| 73562 | X-ray of knee, 3 views | 30 | 24 | $0 |
Insurance plans in this area (ZIP 32212)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| - | WA | |
| Orthopedic Surgery, Hand Surgery | WA | |
| Occupational Therapist In Private Practice | WA | |
| - | WA | |
| Orthopedic Surgery, Sports Medicine | WA | |
| - | WA | |
| - | WA | |
| Physician Assistant | WA | |
| Nurse Practitioner | WA | |
| Nurse Practitioner | WA |
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