Individual provider Active NPI

Linda L. Diedriech, M.D.

  • Internal Medicine Physician
  • Palm Harbor, FL
National Provider Identifier
1033154554
Registry record updated Dec 20, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
ME83838 Issued in FL
Practice address
4705 Alt 19 Ste B
Palm Harbor, FL 34683-1424
Phone
(727) 935-6477
Fax
(727) 935-6478
NPI assigned
Jun 18, 2006
Last updated
Dec 20, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 20, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X ME83838 FL Primary

Addresses

Primary practice location

4705 Alt 19 Ste B
Palm Harbor, FL 34683-1424

Mailing address

4705 Alt 19 Ste B
Palm Harbor, FL 34683-1424
Phone (727) 935-6477

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20100618000266 FL Practitioner - Internal Medicine 2860522869 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Florida Hospital Physician Group Inc Internal Medicine CurrentSince Jan 12, 2019 Accepting new patients

Locations

4705 Alt 19
Ste B
Palm Harbor, FL 34683
Phone (727) 787-4875

13901 Bruce B Downs Blvd
Tampa, FL 33613
Phone (813) 615-7260

2700 Healing Way
Ste 310
Wesley Chapel, FL 33543
Phone (813) 779-1209

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1150588800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1545264000000",
    "number": "1033154554",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4705 ALT 19 STE B",
            "city": "PALM HARBOR",
            "state": "FL",
            "postal_code": "346831424",
            "telephone_number": "727-935-6477",
            "fax_number": "727-935-6478"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4705 ALT 19 STE B",
            "city": "PALM HARBOR",
            "state": "FL",
            "postal_code": "346831424",
            "telephone_number": "727-935-6477",
            "fax_number": "727-935-6478"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIEDRIECH",
        "first_name": "LINDA",
        "middle_name": "L.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-18",
        "last_updated": "2018-12-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ME83838",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Palm Harbor, FL

Sources for this page

Verify at the official NPI Registry.