AMY BETH DETTORI M.D.
NPI 1174751325
Pediatrics - Pediatric Pulmonology in Oak Harbor, WA
NPI Status: Active since June 26, 2009
Contact Information
3475 N SARATOGA ST
BLDG 993
OAK HARBOR, WA
ZIP 98278
Phone: (360) 257-9406
- Individual
- Female
- Pediatrics
- Pediatric Pulmonology
- Accepts Insurance
- PECOS Enrolled
About AMY DETTORI
This page provides the complete NPI Profile along with additional information for Amy Dettori, a pediatrician established in Oak Harbor, Washington with a medical specialization in Pediatrics, focusing in pediatric pulmonology . The healthcare provider is registered in the NPI registry with number 1174751325 assigned on June 2009. The practitioner's primary taxonomy code is 2080P0214X with license number MD61153930 (WA). The provider is registered as an individual and her NPI record was last updated 4 years ago.
- NPI
- 1174751325
- Provider Name
- AMY BETH DETTORI M.D.
- Other Name
- AMY BETH CLARK M.D.
- Other Name Type
- Former Name (1)
- Gender
- Female
- Entity Type
- Individual
- Location Address
- 3475 N SARATOGA ST BLDG 993 OAK HARBOR, WA 98278
- Location Phone
- (360) 257-9406
- Mailing Address
- 6034 40TH AVE NE SEATTLE, WA 98115
- Mailing Phone
- (206) 765-6766
- Is Sole Proprietor?
- No
- Enumeration Date
- 06-26-2009
- Last Update Date
- 06-10-2021
- Code Navigator
A pediatrician like Amy Dettori is a physician who has completed a pediatric residency and is board-certified or board-eligible in a pediatric specialty. Pediatric care providers are trained to care for newborns, infants, children and adolescents. A pediatrician could perform physical exams, manage vaccinations, monitor development milestones, diagnose illnesses, infections, injuries or other health problems, etc.
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Pediatrics Pediatric Pulmonology
- Taxonomy Code
- 2080P0214X
- Type
- Allopathic & Osteopathic Physicians
- License No.
- MD61153930
- License State
- WA
- Taxonomy Description
- A pediatrician dedicated to the prevention and treatment of all respiratory diseases affecting infants, children and young adults. This specialist is knowledgeable about the growth and development of the lung, assessment of respiratory function in infants and children, and experienced in a variety of invasive and noninvasive diagnostic techniques.
Secondary Taxonomies
The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.
| No. | Taxonomy Code | Type | Classification / Specialization |
License No. (State) |
|---|---|---|---|---|
| 1 | 2083A0100X | Allopathic & Osteopathic Physicians | Preventive Medicine | 01068606A (IN) |
| 2 | 390200000X | Student, Health Care | Student in an Organized Health Care Education/Training Program |
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
- Navigator Bronze 7000 Exchange - PPO
- Navigator Bronze 9200 - PPO
- Navigator Bronze HSA 8050 - PPO
- Navigator Gold 1500 - PPO
- Navigator Gold 1500 Exchange - PPO
- Navigator Gold 500 Exchange - PPO
- Navigator Silver 3500 Exchange - PPO
- Navigator Silver 4000 Exchange - PPO
- Navigator Silver 5000 - PPO
- Navigator Silver HSA 3500 - PPO
- Navigator Standard Expanded Bronze - PPO
- Navigator Standard Gold - PPO
- Navigator Standard Silver - PPO
- PacificSource Oregon Standard Bronze Plan NAV - PPO
- PacificSource Oregon Standard Gold Plan NAV - PPO
- PacificSource Oregon Standard Silver Plan NAV - PPO
- Premera Blue Cross Alaska One Gold - PPO
- Premera Blue Cross Preferred Bronze 5800 HSA - PPO
- Premera Blue Cross Preferred Bronze 6350 - PPO
- Premera Blue Cross Preferred Gold 1500 - PPO
- Premera Blue Cross Preferred Silver 4500 - PPO
- Premera Blue Cross Standard Bronze II - PPO
- Premera Blue Cross Standard Gold - PPO
- Premera Blue Cross Standard Silver - PPO
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
Medicare Participation & PECOS Enrollment Status
Amy Dettori is enrolled in PECOS and is eligible to order or refer health care services for Medicare patients. The provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.
What is PECOS?
PECOS is the online Medicare enrollment management system or Provider, Enrollment, Chain and Ownership System. The PECOS system is a database of providers who have registered with CMS as providers or suppliers. PECOS is the primary source of information about verified Medicare professionals. Providers that want to participate in this program need to enroll in PECOS with their NPI number to avoid denied claims.
Is the provider registered in PECOS? Yes
Eligible to Order or Refer Part B Clinical Laboratory and Imaging: Yes
Eligible to Order or Refer Durable Medical Equipment (DMEPOS): Yes
Eligible to Order or Refer a Home Health Agency (HHA): Yes
Eligible to Order or Refer Power Mobility Devices: Yes
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NPI Validation Check Digit Calculation
The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.
| Start with the original NPI number, the last digit is the check digit and is not used in the calculation. | |||||||||
| 1 | 1 | 7 | 4 | 7 | 5 | 1 | 3 | 2 | 5 |
| Step 1: Double the value of the alternate digits, beginning with the rightmost digit. | |||||||||
| 2 | 1 | 14 | 4 | 14 | 5 | 2 | 3 | 4 | |
| Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24. | |||||||||
| 2 + 1 + 1 + 4 + 4 + 1 + 4 + 5 + 2 + 3 + 4 + 24 = 55 | |||||||||
| Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit. | |||||||||
| 60 - 55 = 5 | 5 | ||||||||
The NPI number 1174751325 is valid because the calculated check digit 5 using the Luhn validation algorithm matches the last digit of the original NPI number.
Other Providers at the Same Location
The following 20 providers are registered at the same or nearby location.
| NPI | Name / Type | Taxonomy | Address |
|---|---|---|---|
| 1164428116 | DR. JEFFREY HOWARD DAVIS M.D. Individual | Pediatrics (Pediatric Hematology-Oncology) | 3475 N SARATOGA ST OAK HARBOR, WA 98278 (360) 257-9905 |
| 1164407474 | DR. STEPHEN D MATTSON M.D. Individual | Military Health Care Provider | 3475 N SARATOGA ST OAK HARBOR, WA 98278 (360) 257-9836 |
| 1730168105 | SHUN HUNG LING M.D. Individual | Obstetrics & Gynecology | 3475 N SARATOGA ST DEPT OB/GYN, NAVAL HOSPITAL OAK HARBOR, WA 98278 (360) 257-9917 |
| 1861471153 | DR. MARTIN THOMAS CLARK DDS Individual | Dentist (Prosthodontics) | 3475 N SARATOGA ST OAK HARBOR, WA 98278 (360) 257-4478 |
| 1821078890 | MR. JON ROGER HUBNER PAC Individual | Physician Assistant (Medical) | 3475 N SARATOGA ST OAK HARBOR, WA 98278 (360) 257-9646 |
| 1952381808 | DR. MARK VERNON COLAIANNI D.M.D. Individual | Dentist (General Practice) | 3475 N SARATOGA ST OAK HARBOR, WA 98278 (360) 257-2301 |
| 1184604860 | MS. SUSAN HERROLD FNP Individual | Registered Nurse (Ambulatory Care) | 3475 N SARATOGA ST COMMAND SUITE OAK HARBOR, WA 98278 (360) 257-9974 |
| 1538149786 | ANDREA BRUNHART DONALTY M.D. Individual | Pediatrics | 3475 N SARATOGA ST NAVAL HOSPITAL OAK HARBOR OAK HARBOR, WA 98278 (360) 257-9605 |
| 1871564302 | COLIN G CHINN M.D. Individual | Internal Medicine (Gastroenterology) | 3475 N SARATOGA ST OAK HARBOR, WA 98278 (360) 257-9974 |
| 1740254390 | GARY STEPHEN GANTZ CRNA Individual | Nurse Anesthetist, Certified Registered | 3475 N SARATOGA ST OAK HARBOR, WA 98278 (360) 257-9894 |
| 1821062571 | JOHN LEIGH BOONE Individual | Otolaryngology | 3475 N SARATOGA ST OAK HARBOR, WA 98278 (360) 257-9975 |
| 1679548200 | DR. NANCY GIMBUT HIGHT PHD, CCCA Individual | Audiologist | 3475 N SARATOGA ST OAK HARBOR, WA 98278 (360) 257-9974 |
| 1053387688 | DR. VERNON DALE MORGAN M.D. Individual | Family Medicine | 3475 N SARATOGA ST OAK HARBOR, WA 98278 (360) 257-9918 |
| 1487620084 | DR. DEAN ANGELA WELDON M.D. Individual | Family Medicine | 3475 N SARATOGA ST OAK HARBOR, WA 98278 (360) 257-9505 |
| 1528035359 | JEFFREY A FORD MD Individual | Family Medicine | 3475 N SARATOGA ST OAK HARBOR, WA 98278 (360) 257-9646 |
| 1255308029 | DR. ROBERT JEFFERSON ADAMS M.D. Individual | Family Medicine | 3475 N SARATOGA ST OAK HARBOR, WA 98278 (360) 257-9500 |
| 1396705786 | DR. MICHAEL ERIC WILLIAMS M.D. Individual | Family Medicine | 3475 N SARATOGA ST OAK HARBOR, WA 98278 (360) 257-9502 |
| 1316095847 | MS. NATALIE GWYN LEDBETTER CRNA Individual | Nurse Anesthetist, Certified Registered | 3475 N SARATOGA ST OAK HARBOR, WA 98278 (360) 257-9972 |
| 1811040785 | DR. SAMUEL ALFRED HERBERT PHD Individual | Psychologist (Clinical) | 3475 N SARATOGA ST OAK HARBOR, WA 98278 (360) 257-9859 |
| 1477742872 | MR. RICHARD RYAN TOMLINSON IDC Individual | Military Health Care Provider (Independent Duty Corpsman) | 3475 N SARATOGA ST OAK HARBOR, WA 98278 (360) 257-6876 |
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1174751325, enumerated in the NPI registry as an "individual" on June 26, 2009
The provider is located at 3475 N Saratoga St Bldg 993 Oak Harbor, Wa 98278 and the phone number is (360) 257-9406
The provider's speciality is Pediatrics with taxonomy code 2080P0214X with a focus in Pediatric Pulmonology
The provider might be accepting Accepts: PacificSource Health Plans and Premera Blue Cross. Please consult your insurance carrier or call the provider to make sure your health plan is currently accepted.
Yes, as of June 20, 2025 the provider is registered in PECOS and is eligible to order health care services or supplies for Medicare patients. If you are a beneficiary the provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.
This NPI record was last updated on June 26, 2009. To officially update your NPI information contact the National Plan and Provider Enumeration System (NPPES) at 1-800-465-3203 (NPI Toll-Free) or by email at [email protected].
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