Jaci Rae Dietz

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

3364 Issued in NE

Practice address

816 22ND Ave Ste 100
Kearney, NE 68845-2226

Phone

(308) 865-2263

Fax

(308) 865-2541

NPI assigned

Jul 2, 2024

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NE

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 2025

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Bryan Hospital KearneyGroup PAC ID 5991195547, 116 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Kearney Regional Medical Center Hospital, Kearney, NE, CCN 280134

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Bryan Hospital Kearney

  • Family Medicine Physician
  • Kearney, NE
  • NPI 1033875380
  Medicare reassignment Care Compare group NPD
• Bryan Hospital Kearney

  • General Acute Care Hospital
  • Kearney, NE
  • NPI 1407513484
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Bryan Hospital Kearney

  • General Acute Care Hospital
  • Kearney, NE
  • NPI 1407513484
  Care Compare affiliation

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

{
    "created_epoch": "1719878400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1787184000000",
    "number": "1063258788",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "816 22ND AVE STE 100",
            "city": "KEARNEY",
            "state": "NE",
            "postal_code": "688452226",
            "telephone_number": "308-865-2263",
            "fax_number": "308-865-2541"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "816 22ND AVE STE 100",
            "city": "KEARNEY",
            "state": "NE",
            "postal_code": "688452226",
            "telephone_number": "308-865-2263",
            "fax_number": "308-865-2541"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIETZ",
        "first_name": "JACI",
        "middle_name": "RAE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-07-02",
        "last_updated": "2026-08-20",
        "certification_date": "2026-08-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NE",
            "license": "3364",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Carlos Ariel Diaz
• Mark Diaz
• Nadia Elsie-Jean Diaz
• Eva Dickerman
• Misti Diefenbaugh
• Elena Ann Dille, DAT, LAT, ATC
• Alexandra Louise Dillon
• Alma Dimas
• Maria Dischinger
• Kelly S Dobberstein, PLMHP

• Physician Assistant in Kearney, NE
• Providers in Kearney, NE by specialty
• Physician Assistant in Nebraska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.