Individual provider Active NPI

Marlowe Gates Dieckmann

  • Family Medicine Physician
  • Grass Valley, CA
National Provider Identifier
1003304536
Registry record updated Sep 2, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
A157293 Issued in CA
Practice address
1350 E Main St
Grass Valley, CA 95945-5208
Phone
(530) 477-8545
NPI assigned
Apr 30, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 2, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X A157293 CA Primary

Addresses

Primary practice location

1350 E Main St
Grass Valley, CA 95945-5208

Mailing address

1350 E Main St
Grass Valley, CA 95945-5208
Phone (530) 477-8545

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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

Enrollment IDStateProvider typePAC IDDetails
I20201013001531 CA Practitioner - Family Practice 1456604800 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Louisville School of Medicine, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Chapa-de Indian Health Program, Inc.Group PAC ID 4981688520, 54 clinicians
Grass Valley Radiation OncologyGroup PAC ID 3779902192, 5 clinicians
Dignity Health Medical FoundationGroup PAC ID 7810800661, 1,211 clinicians

Practice addresses (Care Compare)

1350 E Main St
Grass Valley, CA 95945-5208
Phone (530) 477-8545

155 Glasson Way BLDG
3 L 20
Grass Valley, CA 95945-5723
Phone (530) 802-6400

1700 Prairie City Rd
Folsom, CA 95630-9594
Phone (916) 351-4800

Hospital & facility affiliations

  • Northstar Healthcare Services Home health agency, Sacramento, CA, CCN 757243
  • Sierra Nevada Memorial Hospital Hospital, Grass Valley, CA, CCN 050150

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions51
Removal or shaving of skin growth11
Skin biopsy38

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A157293CAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Grass Valley Radiation Oncology CurrentSince Jan 23, 2024 Accepting new patients
Chapa-de Indian Health Program, Inc. CurrentSince Sep 1, 2020 Accepting new patients
Dignity Health Medical Foundation CurrentSince Sep 30, 2022 Accepting new patients
Dignity Health Medical Foundation Current Accepting new patients
Dignity Health Medical Foundation CurrentSince Sep 30, 2022 Accepting new patients
Sierra Nevada Memorial-Miners Hospital PastSince Jan 23, 2024 Accepting new patients

Locations

11670 Atwood Rd
Auburn, CA 95603
Phone (530) 887-2800

155 Glasson Way
Bldg 3
Grass Valley, CA 95945
Phone (530) 274-6600

280 Sierra College Dr
Ste 120
Grass Valley, CA 95945
Phone (530) 477-4420

300 Sierra College Dr
Ste 150
Grass Valley, CA 95945
Phone (530) 274-6600

1350 E Main St
Grass Valley, CA 95945
Phone (530) 477-8545

Interoperability endpoints

  • Direct secure messaging: marlowe.dieckmann@cdih.eclinicaldirectplus.com
  • FHIR API: https://fhir4.healow.com/fhir/r4/AHHIAD

Organizations & group practices 6

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 2

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": "1525046400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1599004800000",
    "number": "1003304536",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1350 E MAIN ST",
            "city": "GRASS VALLEY",
            "state": "CA",
            "postal_code": "959455208",
            "telephone_number": "530-477-8545"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1350 E MAIN ST",
            "city": "GRASS VALLEY",
            "state": "CA",
            "postal_code": "959455208",
            "telephone_number": "530-477-8545"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIECKMANN",
        "first_name": "MARLOWE",
        "middle_name": "GATES",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-04-30",
        "last_updated": "2020-09-02",
        "certification_date": "2020-09-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A157293",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grass Valley, CA

Sources for this page

Verify at the official NPI Registry.