Individual provider Active NPI

Tori Nicole Diedring, DO

  • Dermatology Physician
  • Indianapolis, IN
National Provider Identifier
1033747688
Registry record updated Jul 3, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
02008293A Issued in IN
Practice address
7910 N Shadeland Ave
Indianapolis, IN 46250-2041
Phone
(317) 516-5000
NPI assigned
Mar 30, 2020
Last updated
Jul 3, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 3, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X NU
Dermatology Physician 207N00000X 5101027931 MI
Dermatology Physician 207N00000X 02008293A IN Primary

Addresses

Primary practice location

7910 N Shadeland Ave
Indianapolis, IN 46250-2041

Mailing address

7910 N Shadeland Ave
Indianapolis, IN 46250-2041
Phone (317) 516-5000

Other practice location 1

28333 Harper Ave
Saint Clair Shores, MI 48081-1687
Phone (586) 776-9770

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI, IN2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20240628002243 MI Practitioner - Dermatology 8729406897 Reassigns benefits to 1 organization
I20250626002913 IN Practitioner - Dermatology 8729406897 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Dermatology
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Dawes Fretzin Dermatology Group, LLCGroup PAC ID 8820990872, 20 clinicians

Practice addresses (Care Compare)

7910 N Shadeland Ave
Indianapolis, IN 46250-2041
Phone (317) 516-5000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
92.46 of 100Reported as group
Quality
91.13
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision1-10
Removal of skin lesions652
Removal or shaving of skin growth136
Skin biopsy167

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Midwest Center for Dermatology & Pathology, PLLC Single Specialty CurrentSince Aug 5, 2024 Accepting new patients
Dawes Fretzin Dermatology Group, LLC Single Specialty CurrentSince Jul 28, 2025 Accepting new patients
Michigan Center for Dermatology & Pathology, PLLC Single Specialty Past Accepting new patients
Stephen I. Field, M.D., P.C. Single Specialty PastSince Jun 1, 2024 Accepting new patients
Dermatopathology Laboratory of Central States Dermatology PastSince Oct 6, 2018 Accepting new patients

Locations

7910 N Shadeland Ave
Indianapolis, IN 46250

43900 Garfield Rd
Ste 100
Clinton Twp, MI 48038
Phone (586) 286-0112

28333 Harper Ave
St Clr Shores, MI 48081
Phone (586) 776-9770

Interoperability endpoints

  • Direct secure messaging: tdiedring@directaddress.net
  • Direct secure messaging: tdiedring@mwcd.emadirect.md

Organizations & group practices 5

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.

Hospital & facility affiliations 1

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": "1585526400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1751500800000",
    "number": "1033747688",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7910 N SHADELAND AVE",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462502041",
            "telephone_number": "317-516-5000",
            "fax_number": "317-516-5001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7910 N SHADELAND AVE",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462502041",
            "telephone_number": "317-516-5000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "28333 Harper Ave",
            "address_purpose": "LOCATION",
            "city": "Saint Clair Shores",
            "state": "MI",
            "postal_code": "480811687",
            "country_code": "US",
            "telephone_number": "586-776-9770",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DIEDRING",
        "first_name": "TORI",
        "middle_name": "NICOLE",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-03-30",
        "last_updated": "2025-07-03",
        "certification_date": "2025-07-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "MI",
            "license": "5101027931",
            "primary": false
        },
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "IN",
            "license": "02008293A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Indianapolis, IN

Sources for this page

Verify at the official NPI Registry.