Deidre Anne Dietz, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

036.125780 Issued in IL

Practice address

3223 W 63Rd Street
Chicago, IL 60629

Phone

(773) 768-5000

NPI assigned

Jun 22, 2007

Sex

Female

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 1

Other names 1

• Deidre Anne Schupbach Former name

Medicare fee-for-service enrollment

Enrolled in CO

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: ddietz7523@direct.dhha.org

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.

• Denver Health and Hospital Authority

  • General Practice Physician
  • Denver, CO
  • NPI 1477569838
  Medicare reassignment NPD
• Denver Health and Hospital Authority

  • Psychiatric Hospital Unit
  • Denver, CO
  • NPI 1689624942
  NPD
• Denver Health and Hospital Authority

  • Federally Qualified Health Center (FQHC)
  • Denver, CO
  • NPI 1922049014
  NPD (past)

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

{
    "created_epoch": "1182470400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1315353600000",
    "number": "1245436625",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9119 S EXCHANGE AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606174225",
            "telephone_number": "773-768-5000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3223 W 63RD STREET",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "60629",
            "telephone_number": "773-768-5000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIETZ",
        "first_name": "DEIDRE",
        "middle_name": "ANNE",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-06-22",
        "last_updated": "2011-09-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036.125780",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRAINING",
            "identifier": "RS2000-0373",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DEIDRE",
            "last_name": "SCHUPBACH",
            "middle_name": "ANNE",
            "credential": "M.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Hannah Lane Dietrich, APRN
• Jonathan Jacob Dietrich, MD
• Kelly Dietrick
• Nancy Ann Diettrich, MD
• Bridget Dietz, LCSW
• Hannah R Dietz
• James Dietz, LPC
• Anton N Dietzen, M.D., D.C.
• Richard J Dietzen, DC
• Ann Kathleen Dieudonne Ndinga, FNP-BC

• Family Medicine Physician in Chicago, IL
• Providers in Chicago, IL by specialty
• Family Medicine Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 7, 2011; 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.