Individual provider Active NPI

Kent A Diehl, MD

  • Family Medicine Physician
  • Flagstaff, AZ
National Provider Identifier
1194745133
Registry record updated Mar 14, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
46375 Issued in AZ
Practice address
107 E Oak Ave
Suite 201
Flagstaff, AZ 86001-1818
Phone
(928) 913-8800
Fax
(928) 913-8801
NPI assigned
Jul 20, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 14, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 46375 AZ Primary

Addresses

Primary practice location

107 E Oak Ave
Suite 201
Flagstaff, AZ 86001-1818

Mailing address

1200 N Beaver St
Payer Credentialing
Flagstaff, AZ 86001-3118
Phone (928) 773-2559

Other identifiers 2

IdentifierTypeStateIssuer
737449MedicaidAZ
P01574368OtherAZRAILROAD MEDICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ND, AZ2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20031208001046 ND Practitioner - Family Practice 1052217411 Reassigns benefits to 2 organizations
I20121121000194 AZ Practitioner - Family Practice 1052217411 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
93.78 of 100Reported as apm
Quality
80.38
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
46375AZMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Lutheran Charity Association Current Accepting new patients
Four Seasons Wellness, PLLC CurrentSince Jan 1, 2017 Accepting new patients
Lutheran Charity Association CurrentSince Jul 9, 2018 Accepting new patients
Lutheran Charity Association CurrentSince Jul 9, 2018 Accepting new patients
Northwest Allied Physicians, LLC CurrentSince Oct 8, 2012 Accepting new patients
Northwest Allied Physicians LLC CurrentSince Oct 8, 2012 Accepting new patients
Hospice Inspiris LLC Past Accepting new patients

Locations

12080 N Dove Mountain Blvd
Ste 140
Marana, AZ 85658
Phone (520) 367-2742

1521 E Tangerine Rd
Ste 337
Oro Valley, AZ 85755
Phone (520) 825-0300

1521 E Tangerine Rd
Ste 131
Oro Valley, AZ 85755
Phone (520) 297-9846

1521 E Tangerine Rd
Ste 315
Oro Valley, AZ 85755
Phone (520) 742-1565

13101 N Oracle Rd
Ste 100
Tucson, AZ 85739
Phone (520) 797-9850

13101 N Oracle Rd
Ste 157
Tucson, AZ 85739
Phone (520) 818-5490

8333 N Silverbell Rd
Ste 161
Tucson, AZ 85743
Phone (520) 202-7770

2422 20th St SW
Jamestown, ND 58401
Phone (701) 252-1050

Organizations & group practices 7

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.

NPI Registry JSON

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

{
    "created_epoch": "1153353600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1489449600000",
    "number": "1194745133",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 N BEAVER ST",
            "address_2": "PAYER CREDENTIALING",
            "city": "FLAGSTAFF",
            "state": "AZ",
            "postal_code": "860013118",
            "telephone_number": "928-773-2559",
            "fax_number": "928-213-6292"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "107 E OAK AVE",
            "address_2": "SUITE 201",
            "city": "FLAGSTAFF",
            "state": "AZ",
            "postal_code": "860011818",
            "telephone_number": "928-913-8800",
            "fax_number": "928-913-8801"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIEHL",
        "first_name": "KENT",
        "middle_name": "A",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-20",
        "last_updated": "2017-03-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AZ",
            "license": "46375",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "737449",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P01574368",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Flagstaff, AZ

Sources for this page

Verify at the official NPI Registry.