Active NPI 1700122587 Individual Practitioner Male Practitioner

Nicholas D Debolt , PA-C

Physician Assistant - Surgical • Tulsa, OK

✓ Accepts Medicare Assignment

Professional Overview & Biography Verified Profile Summary

Nicholas Debolt, PA-C is a certified Physician Assistant - Surgical practicing in Tulsa, OK. With approximately 14 years of clinical experience since completing medical education in 2012, Nicholas Debolt delivers high-quality medical care to the local community at 2488 E 81ST ST STE 290.

Nicholas Debolt is affiliated with Advanced Orthopedics Of Oklahoma Pllc and accepts Medicare assignment.

Frequently performed procedures and clinical services include injection, triamcinolone acetonide, not otherwise specified, 10 mg, injection, betamethasone acetate 3 mg and betamethasone sodium phosphate 3 mg, aspiration and/or injection of fluid from large joint. Full Medicare procedure pricing transparency rates and service volume details are listed on this profile.

Practice Location & Contact Primary Location

Practice Address

2488 E 81st St Ste 290

Tulsa, OK 741374265

Telephone 9184942665

Fax 9189273201

Associated Practice Facility / Clinic

🏢 Advanced Orthopedics Of Oklahoma Pllc Facility NPI 1457790545

Medicare Profile & Education

Medical School

Other

Graduation Year

2012

Medicare Assignment

✓ Accepts Assignment

Telehealth Flag

In-Person Only

Specialty Benchmarks & Practice Insights

Comparative analytics for Physician Assistant - Surgical in Tulsa, OK

Established Specialist (10-20 Yrs)

Practitioner Clinical Experience

14 Yrs +3.2 yrs vs City Avg

City Avg: 10.8 Yrs

State Avg: 15.0 Yrs

Regional Practice Density

39 Specialists

Practicing in Tulsa, OK (113 Statewide)

Telehealth Adoption Rate

5.1% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount

76.5% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Clinical Seniority & Experience Comparison

Dr. Debolt (14 Years) 14 Yrs

Tulsa Specialty Average (10.8 Years) 10.8 Yrs

Performed Procedures & Service Volume

Top Medicare Part B procedures performed by this practitioner

CMS Official Data (2024)

Reporting Year:

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
J3301 Injection, triamcinolone acetonide, not otherwise specified, 10 mg	670	81	$6.58	$1.00
J0702 Injection, betamethasone acetate 3 mg and betamethasone sodium phosphate 3 mg	645	115	$21.21	$6.97
20610 Aspiration and/or injection of fluid from large joint	263	143	$234.13	$54.59
99213 Established patient office or other outpatient visit, typically 15 minutes	147	111	$230.62	$70.59
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	115	96	$358.16	$99.95
73030 X-ray of shoulder, minimum of 2 views	99	73	$92.29	$26.26
73564 X-ray of knee, 4 or more views	49	41	$122.20	$35.73
J7327 Hyaluronan or derivative, monovisc, for intra-articular injection, per dose	47	35	$3172.63	$680.27
73562 X-ray of knee, 3 views	30	24	$114.63	$30.88
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	24	23	$143.47	$44.07
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	12	12	$549.47	$132.26
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	11	11	$359.28	$87.48

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
J0702 Injection, betamethasone acetate 3 mg and betamethasone sodium phosphate 3 mg	930	127	$21.21	$6.62
J3304 Injection, triamcinolone acetonide, preservative-free, extended-release, microsphere formulation, 1 mg	672	11	$66.50	$16.72
J3301 Injection, triamcinolone acetonide, not otherwise specified, 10 mg	477	74	$6.58	$1.06
20610 Aspiration and/or injection of fluid from large joint	268	152	$230.51	$53.56
99213 Established patient office or other outpatient visit, typically 15 minutes	160	115	$230.62	$70.77
73030 X-ray of shoulder, minimum of 2 views	102	78	$93.56	$26.50
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	82	68	$358.16	$99.34
73562 X-ray of knee, 3 views	61	47	$114.63	$30.71
73564 X-ray of knee, 4 or more views	51	44	$127.40	$35.41
J7327 Hyaluronan or derivative, monovisc, for intra-articular injection, per dose	47	35	$3172.63	$699.92
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	26	26	$359.28	$88.63
29826 Shaving of part of shoulder bone and repair of ligament using an endoscope	19	19	$232.56	$20.92
27447 Replacement of knee joint, both sides of knee	18	18	$697.04	$162.73
29824 Partial removal of collar bone at shoulder using an endoscope	18	18	$338.71	$61.80
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	15	15	$143.47	$44.37
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	13	13	$549.47	$132.25

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
J0702 Injection, betamethasone acetate 3 mg and betamethasone sodium phosphate 3 mg	727	105	$21.21	$6.68
J3304 Injection, triamcinolone acetonide, preservative-free, extended-release, microsphere formulation, 1 mg	608	11	$66.50	$16.99
J3301 Injection, triamcinolone acetonide, not otherwise specified, 10 mg	480	66	$6.58	$1.13
20610 Aspiration and/or injection of fluid from large joint	237	133	$243.57	$55.72
99213 Established patient office or other outpatient visit, typically 15 minutes	159	119	$230.62	$72.18
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	124	104	$358.16	$101.59
73030 X-ray of shoulder, minimum of 2 views	109	88	$93.56	$27.03
73562 X-ray of knee, 3 views	74	56	$114.63	$31.88
73564 X-ray of knee, 4 or more views	44	39	$130.30	$36.05
J7327 Hyaluronan or derivative, monovisc, for intra-articular injection, per dose	37	27	$3172.63	$755.66
27447 Replacement of knee joint, both sides of knee	35	34	$697.04	$165.18
29826 Shaving of part of shoulder bone and repair of ligament using an endoscope	29	29	$232.56	$21.97
29824 Partial removal of collar bone at shoulder using an endoscope	19	19	$338.71	$68.87
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	16	16	$359.28	$89.32
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	16	16	$549.47	$127.50
29827 Repair of shoulder rotator cuff using an endoscope	13	13	$540.06	$131.72

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
J0702 Injection, betamethasone acetate 3 mg and betamethasone sodium phosphate 3 mg	699	96	$21.21	$6.86
J3304 Injection, triamcinolone acetonide, preservative-free, extended-release, microsphere formulation, 1 mg	544	11	$66.50	$17.89
J3301 Injection, triamcinolone acetonide, not otherwise specified, 10 mg	471	63	$6.58	$1.27
20610 Aspiration and/or injection of fluid from large joint	211	119	$258.23	$56.83
99213 Established patient office or other outpatient visit, typically 15 minutes	155	120	$230.62	$73.30
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	93	85	$358.16	$102.63
73030 X-ray of shoulder, minimum of 2 views	89	70	$93.56	$26.41
73562 X-ray of knee, 3 views	53	40	$114.63	$30.98
73564 X-ray of knee, 4 or more views	46	38	$127.40	$35.73
J7327 Hyaluronan or derivative, monovisc, for intra-articular injection, per dose	39	29	$3172.63	$768.34
29826 Shaving of part of shoulder bone and repair of ligament using an endoscope	32	31	$232.56	$22.78
29824 Partial removal of collar bone at shoulder using an endoscope	30	29	$338.71	$59.36
27447 Replacement of knee joint, both sides of knee	28	26	$771.92	$159.07
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	22	19	$143.47	$44.91
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	18	18	$549.47	$135.75
29827 Repair of shoulder rotator cuff using an endoscope	17	17	$540.06	$139.27
23472 Prosthetic repair of shoulder joint, total shoulder	12	12	$748.27	$188.89
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	11	11	$359.28	$90.39

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99213 Established patient office or other outpatient visit, typically 15 minutes	280	235	$173.27	$60.20
73564 X-ray of knee, 4 or more views	275	210	$99.07	$33.91
27447 Replacement of knee joint, both sides of knee	219	202	$781.15	$177.28
J1030 Injection, methylprednisolone acetate, 40 mg	124	32	$15.14	$6.10
20610 Aspiration and/or injection of fluid from large joint	100	73	$220.71	$56.48
J0702 Injection, betamethasone acetate 3 mg and betamethasone sodium phosphate 3 mg	98	26	$21.21	$6.55
J3301 Injection, triamcinolone acetonide, not otherwise specified, 10 mg	93	20	$6.68	$1.33
73502 X-ray of hip, 2-3 views	77	60	$93.00	$35.13
27130 Replacement of thigh bone and hip joint with prosthesis	52	50	$729.52	$178.53
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	37	37	$288.50	$88.31
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	26	26	$107.72	$36.31
73030 X-ray of shoulder, minimum of 2 views	22	19	$93.56	$25.89
73562 X-ray of knee, 3 views	18	16	$112.93	$30.49
27486 Revision of component of total knee joint prosthesis	13	12	$712.36	$187.19

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99213 Established patient office or other outpatient visit, typically 15 minutes	231	174	$162.00	$59.52
73564 X-ray of knee, 4 or more views	205	168	$97.29	$31.98
J1030 Injection, methylprednisolone acetate, 40 mg	106	36	$15.00	$6.22
27447 Replacement of knee joint, both sides of knee	99	97	$779.46	$180.07
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	84	82	$97.00	$35.79
73630 X-ray of foot, minimum of 3 views	69	41	$72.00	$24.25
20610 Aspiration and/or injection of fluid from large joint	59	44	$214.24	$57.48
73502 X-ray of hip, 2-3 views	53	43	$91.72	$32.81
73610 X-ray of ankle, minimum of 3 views	30	24	$125.00	$25.91
27130 Replacement of thigh bone and hip joint with prosthesis	26	26	$729.52	$175.05
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	22	21	$241.00	$87.31
29405 Application of short leg cast	21	14	$185.00	$64.73
Q4038 Cast supplies, short leg cast, adult (11 years +), fiberglass	21	14	$72.00	$41.75
72100 X-ray of lower and sacral spine, 2-3 views	12	12	$84.00	$28.42
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	12	12	$242.00	$86.85

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99213 Established patient office or other outpatient visit, typically 15 minutes	135	88	$162.00	$58.64
73630 X-ray of foot, minimum of 3 views	51	35	$72.00	$22.90
29405 Application of short leg cast	44	27	$185.00	$65.42
J1030 Injection, methylprednisolone acetate, 40 mg	44	21	$15.00	$6.72
Q4038 Cast supplies, short leg cast, adult (11 years +), fiberglass	42	26	$72.00	$40.81
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	40	37	$241.00	$86.70
20610 Aspiration and/or injection of fluid from large joint	40	28	$190.70	$53.92
73610 X-ray of ankle, minimum of 3 views	37	25	$125.00	$24.53
73564 X-ray of knee, 4 or more views	35	25	$95.91	$30.22
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	24	19	$97.00	$34.94
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	14	14	$372.00	$133.57
29826 Shaving of part of shoulder bone and repair of ligament using an endoscope	12	12	$165.00	$23.60
29824 Partial removal of collar bone at shoulder using an endoscope	11	11	$339.24	$36.92

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99213 Established patient office or other outpatient visit, typically 15 minutes	214	136	$162.00	$58.08
73564 X-ray of knee, 4 or more views	48	31	$96.48	$30.03
73630 X-ray of foot, minimum of 3 views	48	36	$72.00	$22.36
73610 X-ray of ankle, minimum of 3 views	36	21	$125.00	$24.21
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	31	28	$97.00	$34.41
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	27	25	$241.00	$85.68
Q4038 Cast supplies, short leg cast, adult (11 years +), fiberglass	26	20	$72.00	$40.36
29405 Application of short leg cast	24	18	$185.00	$64.93
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	17	17	$372.00	$131.74
20610 Aspiration and/or injection of fluid from large joint	15	12	$164.27	$50.01
72110 X-ray of lower and sacral spine, minimum of 4 views	15	15	$114.00	$37.73

Medical Specialties & State Licenses

CMS Verified: 2020-10-08

Physician Assistant - Surgical Primary Specialty

NUCC Taxonomy Code: 363AS0400X

State License OK 2194

Definition to come...

Physician Assistant

NUCC Taxonomy Code: 363A00000X

A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.

Additional State Medicaid & Healthcare Payer Identifiers

Medicaid State Provider ID

200472630A (OK)

Hospital & Practice Group Affiliations

Advanced Orthopedics Of Oklahoma Pllc

205 E B St, Jenks, OK 740373906

Phone: 9182997937

Advanced Orthopedics Of Oklahoma Pllc

2488 E 81st St, Tulsa, OK 741374265

Phone: 9184942665

Secondary Practice Locations

1809 E 13th St

Tulsa, OK 741044419

Phone: 9185826100

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

40 Associated Practitioners

Bailey Clark , PTA

Physical Therapy Assistant

NPI 1003572876

Physical Therapist Assistant

William Stephens , PA-C

Physician Assistant

NPI 1023346863

Physician Assistant (Certified)

Joseph Mahaffey , PA-C

Physician Assistant

NPI 1033458633

Physician Assistant (Certified)

Dr. Ladamian Wilson , DPT

Physical Therapist

NPI 1033756804

Doctor of Physical Therapy

Dr. Jay Lorton , MD

Orthopaedic Surgery

NPI 1043211980

Doctor of Medicine (M.D.)

Summer Thompson

Physical Therapist

NPI 1063230712

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

8 Historical Events

📍

Updated Practice Location October 08, 2020

Registered at 2488 E 81ST ST STE 290, TULSA, OK 741374265 (Tel: 9184942665)

📍

Updated Business Mailing Address October 08, 2020

Registered at 2488 E 81ST ST STE 290, TULSA, OK 741374265 (Tel: 9189273226)

✅

NPI Profile Active May 24, 2016

NPI status registered as active in NPPES database

📍

Updated Practice Location May 24, 2016

Registered at 1809 E 13TH ST, TULSA, OK 741044419 (Tel: 9185826100)

📍

Updated Business Mailing Address May 24, 2016

Registered at 7707 S GUTHRIE AVE, TULSA, OK 741322833 (Tel: 9186881988)

👤

Provider Name / Credentials Updated May 24, 2016

Recorded as NICHOLAS DEBOLT, PA-C

🎓

Medical Taxonomy / Specialty Registered (Primary Specialty) May 24, 2016

Physician Assistant

🟢

Initial NPI Registration & Enumeration December 23, 2012

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1700122587

Entity Type:

Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)

Enumeration Date: December 23, 2012

Last Update: October 08, 2020

Sole Proprietor: No

Update or Correct Profile

Mailing Address

2488 E 81st St Ste 290

Tulsa, OK 741374265

Phone: 9189273226

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).

⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.