Michael A Dieter, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA10002321 Issued in WA

Practice address

601 W 5TH Ave Ste 500
Spokane, WA 99204-2756

Phone

(509) 344-8672

Fax

(509) 747-7838

NPI assigned

Mar 14, 2006

Last updated

Nov 15, 2024By the provider in NPPES

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 10

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

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.

• Northwest Orthopaedic Specialists PS

  • Orthopaedic Surgery Physician
  • Spokane, WA
  • NPI 1609845825
  NPD (past)

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

{
    "created_epoch": "1142294400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731628800000",
    "number": "1134198054",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "601 W 5TH AVE STE 400",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992042715",
            "telephone_number": "509-344-2663",
            "fax_number": "509-624-9179"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "601 W 5TH AVE STE 500",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992042756",
            "telephone_number": "509-344-8672",
            "fax_number": "509-747-7838"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIETER",
        "first_name": "MICHAEL",
        "middle_name": "A",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-14",
        "last_updated": "2024-11-15",
        "certification_date": "2024-11-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WA",
            "license": "PA10002321",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OWCP",
            "identifier": "379109600",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8387292",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "970027249",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "806174800",
            "state": "ID"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CRIME VICTIMS",
            "identifier": "8934606",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ASURIS NW HEALTH",
            "identifier": "4305DI",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS OF ID",
            "identifier": "K6401",
            "state": "ID"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "REGENCE BLUE SHIELD OF ID",
            "identifier": "000010149524",
            "state": "ID"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DEPT OF LABOR & INDUSTRIE",
            "identifier": "0156193",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP HEALTH NW",
            "identifier": "5847",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• David Dierdorff, DC
• Karina Dierks, M.D.
• Savannah Dierks
• Travis Wade Dierks, M.D.
• Marisa Kalie Dieter, ARNP
• Robert D. Dieter, PA-C
• Emily S Dietz, ARNP
• Ryan Dietz
• Michaele Eileen Dietzel
• Mary Ann Dietzen, PH.D.

• Physician Assistant in Spokane, WA
• Providers in Spokane, WA by specialty
• Physician Assistant in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.