John Dietrick III, M.D.

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

ME88224 Issued in FL

Practice address

3000 Medical Park Dr
Suite 330
Tampa, FL 33613-4680

Phone

(813) 971-2470

Fax

(813) 971-2491

NPI assigned

Oct 25, 2006

Last updated

Dec 19, 2008By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

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 Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jdietrickiii74061@adventhealth.direct-ci.com

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.

• Florida Hospital Physician Group Inc

  dba AdventHealth Medical Group

  • Family Medicine Physician
  • Tampa, FL
  • NPI 1174955256

  Surgery

  Medicare reassignment NPD
• John a Dietrick M D P L

  • Surgery Physician
  • Tampa, FL
  • NPI 1982889507
  NPD (past) Authorized official

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

{
    "created_epoch": "1161734400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1229644800000",
    "number": "1124103528",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1904 W MORRISON AVE",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336062831",
            "telephone_number": "813-258-9864"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3000 MEDICAL PARK DR",
            "address_2": "SUITE 330",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336134680",
            "telephone_number": "813-971-2470",
            "fax_number": "813-971-2491"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIETRICK",
        "first_name": "JOHN",
        "name_suffix": "III",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-25",
        "last_updated": "2008-12-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "FL",
            "license": "ME88224",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "273011100",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jerry A Diehr
• Trang Thuy Diep
• Amanda Dieppa
• Diesel Health and Recovery, LLC.
• Amanda Cara Dietrich, M.ED. CCC-SLP
• Garrett Adam Dietz, DPT
• Rod K Dietz, D.D.S.
• Jean V. Dieudonne, PHARM D.
• Michael Anthony Diez, DMD
• Randall Albert Diez, D.M.D.

• Surgery Physician in Tampa, FL
• Providers in Tampa, FL by specialty
• Surgery Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 19, 2008; 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.