Individual provider Active NPI

Daniel Scott Dietrich, MD

  • Diagnostic Radiology Physician
  • Stockton, CA
National Provider Identifier
1053341669
Registry record updated Sep 15, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
A95731 Issued in CA
Practice address
546 E Pine St
Stockton, CA 95204-5525
Phone
(209) 467-1000
Fax
(209) 464-4439
NPI assigned
Jul 3, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 15, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X A95731 CA Primary

Addresses

Primary practice location

546 E Pine St
Stockton, CA 95204-5525

Mailing address

546 E Pine St
Stockton, CA 95204-5525
Phone (209) 467-1000

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
I20080425000659 CA Practitioner - Diagnostic Radiology 3375621600 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Uniformed Services Uhs Fe Hebert School of Med, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Valley MRI and Radiology IncGroup PAC ID 0941470223, 9 clinicians

Practice addresses (Care Compare)

546 E Pine St
Stockton, CA 95204-5525
Phone (209) 467-1000

Merit-based Incentive Payment System (MIPS)

Final score
0 of 100Reported as individual
Quality
0
Improvement activities
0
Cost
0

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Valley MRI and Radiology Inc Diagnostic Radiology CurrentSince Sep 1, 2011 Accepting new patients

Locations

801 S Ham Ln
Ste Q
Lodi, CA 95242

801 S Ham Ln
Ste R
Lodi, CA 95242
Phone (209) 366-1000

801 S Ham Ln
Lodi, CA 95242
Phone (209) 366-1000

3031 W March Ln
Ste 336E
Stockton, CA 95219
Phone (209) 957-3821

546 E Pine St
Ste A
Stockton, CA 95204

546 E Pine St
Stockton, CA 95204
Phone (209) 467-1000

1801 Colorado Ave
Ste 330
Turlock, CA 95382

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1151884800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1505433600000",
    "number": "1053341669",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "546 E PINE ST",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "952045525",
            "telephone_number": "209-467-1000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "546 E PINE ST",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "952045525",
            "telephone_number": "209-467-1000",
            "fax_number": "209-464-4439"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIETRICH",
        "first_name": "DANIEL",
        "middle_name": "SCOTT",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-03",
        "last_updated": "2017-09-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "CA",
            "license": "A95731",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Stockton, CA

Sources for this page

Verify at the official NPI Registry.