David Daniel Dieterich, DO

Primary specialty

Cardiovascular Disease PhysicianTaxonomy code 207RC0000X

License

053669 Issued in FL

Practice address

455 Pinellas St
Suite 400
Clearwater, FL 33756-3356

Phone

(727) 445-1991

Fax

(727) 445-1986

NPI assigned

Oct 18, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy, Doctor of Medicine

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.

• Morton Plant Mease Health Services Inc

  • Diagnostic Radiology Physician
  • Largo, FL
  • NPI 1528049962
  Medicare reassignment NPD
• Pinellas Ekg Interpreters Inc

  • Cardiovascular Disease Physician
  • Clearwater, FL
  • NPI 1013952977
  Medicare reassignment NPD
• Morton Plant Mease Health Services Inc

  • Diagnostic Radiology Physician
  • Safety Harbor, FL
  • NPI 1316576705
  NPD

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

{
    "created_epoch": "1129593600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1351209600000",
    "number": "1083603591",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "455 PINELLAS ST",
            "address_2": "SUITE 400",
            "city": "CLEARWATER",
            "state": "FL",
            "postal_code": "337563356",
            "telephone_number": "727-445-1992",
            "fax_number": "727-445-1993"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "455 PINELLAS ST",
            "address_2": "SUITE 400",
            "city": "CLEARWATER",
            "state": "FL",
            "postal_code": "337563356",
            "telephone_number": "727-445-1991",
            "fax_number": "727-445-1986"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIETERICH",
        "first_name": "DAVID",
        "middle_name": "DANIEL",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-18",
        "last_updated": "2012-10-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "FL",
            "license": "053669",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "065988600",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "82318X",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Laurine Sandy Severine Dicosimo, PCD(DONA)
• Danielle Eugena Dicosola
• Michael V Didonna, DO
• Diehl Chiropractic Inc
• Nathan Jerold Diehl, PA
• Roseland Kay Dietz, CRNA
• Leilani Diggs
• Joseph Digiovanna, PT
• Donald Anthony Diienno, M.D.
• Donna Diliberto, PHARMD

• Cardiovascular Disease Physician in Clearwater, FL
• Providers in Clearwater, FL by specialty
• Cardiovascular Disease Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 2012; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.