Individual provider Active NPI

Raymond A Dieter III, MD

  • Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
  • Knoxville, TN
National Provider Identifier
1063405603
Registry record updated Mar 5, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Thoracic Surgery (Cardiothoracic Vascular Surgery) PhysicianTaxonomy code 208G00000X
License
021978 Issued in TN
Practice address
1940 Alcoa Hwy
Suite E310
Knoxville, TN 37920-2244
Phone
(865) 305-6955
Fax
(865) 637-5216
NPI assigned
Aug 30, 2005
Last updated
Mar 5, 2010By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 5, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician 208G00000X 021978 TN Primary

Addresses

Primary practice location

1940 Alcoa Hwy
Suite E310
Knoxville, TN 37920-2244

Mailing address

PO Box 440547
Nashville, TN 37244-0547
Phone (865) 670-6199

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
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
I20090610000438 TN Practitioner - Cardiac SurgeryPractitioner - Cardiovascular Disease (Cardiology)Practitioner - Thoracic Surgery 2769532902 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Cardiac SurgeryAlso: Thoracic Surgery
Education
R Franklin University of Med & Sci/Chicago Medical School, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
University Health System, Inc.Group PAC ID 5294646378, 512 clinicians

Practice addresses (Care Compare)

1924 Alcoa Hwy
Knoxville, TN 37920-1511

1940 Alcoa Hwy
Knoxville, TN 37920-2263
Phone (865) 305-6810

1940 Alcoa Hwy
Suite E260
Knoxville, TN 37920-2266
Phone (865) 305-6955

1940 Alcoa Hwy E 260
Knoxville, TN 37920-2263
Phone (865) 524-7471

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
96.48 of 100Reported as apm
Quality
86.23
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Coronary angioplasty and stenting1-10
Coronary artery bypass graft (CABG)24

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
021978TNMDThoracic Surgery (Cardiothoracic Vascular Surgery) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University Health System Inc Thoracic Surgery (Cardiothoracic Vascular Surgery) CurrentSince Jun 1, 2009 Accepting new patients
University Health System, Inc Thoracic Surgery (Cardiothoracic Vascular Surgery) CurrentSince Jun 1, 2009 Accepting new patients
University Health System, Inc Current Accepting new patients
University Health System, Inc. Past Accepting new patients
Knoxville Neurology Specialists, PLLC Past Accepting new patients

Locations

1924 Alcoa Hwy
Knoxville, TN 37920
Phone (865) 305-9000

1928 Alcoa Hwy
Ste 300
Knoxville, TN 37920
Phone (615) 637-6392

1940 Alcoa Hwy
Ste E260
Knoxville, TN 37920
Phone (865) 305-6955

1940 Alcoa Hwy
Ste E310
Knoxville, TN 37920
Phone (865) 544-4280

9000 Executive Park Dr
Ste C200
Knoxville, TN 37923
Phone (865) 670-6142

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 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": "1125360000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1267747200000",
    "number": "1063405603",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 440547",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372440547",
            "telephone_number": "865-670-6199",
            "fax_number": "865-670-6188"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1940 ALCOA HWY",
            "address_2": "SUITE E310",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379202244",
            "telephone_number": "865-305-6955",
            "fax_number": "865-637-5216"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIETER",
        "first_name": "RAYMOND",
        "middle_name": "A",
        "name_suffix": "III",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-30",
        "last_updated": "2010-03-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208G00000X",
            "taxonomy_group": "",
            "desc": "Thoracic Surgery (Cardiothoracic Vascular Surgery)",
            "state": "TN",
            "license": "021978",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Knoxville, TN

Sources for this page

Verify at the official NPI Registry.