NPIMap

Individual provider Active NPI

Michael J Diehl, MD

  • Interventional Cardiology Physician
  • Ogden, UT
National Provider Identifier
1265427371
Registry record updated Jan 20, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Interventional Cardiology PhysicianTaxonomy code 207RI0011X
License
295996-1205 Issued in UT
Practice address
5405 S 500 E
Suite #204
Ogden, UT 84405-6957
Phone
(801) 479-0184
Fax
(801) 479-5642
NPI assigned
Sep 14, 2005
Last updated
Jan 20, 2015By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 20, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X 295996-1205 UT
Interventional Cardiology Physician 207RI0011X 295996-1205 UT Primary

Addresses

Primary practice location

5405 S 500 E
Suite #204
Ogden, UT 84405-6957

Mailing address

520 Medical Dr
Suite #310
Bountiful, UT 84010-4968
Phone (801) 397-3000

Other identifiers 1

IdentifierTypeStateIssuer
1477643179OtherGROUP NPI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MP, MA2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20180918001864 MP Practitioner - Cardiovascular Disease (Cardiology) 0345224499 Reassigns benefits to 1 organization
I20191025001954 MA Practitioner - Cardiovascular Disease (Cardiology)Practitioner - Interventional Cardiology 0345224499 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)Also: Interventional Cardiology
Education
University of Florida College of Medicine, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Berkshire Faculty Services IncGroup PAC ID 8224068424, 276 clinicians

Practice addresses (Care Compare)

29 Lewis Ave
Great Barrington, MA 01230-1713
Phone (413) 854-9777

725 N St
Pittsfield, MA 01201-4109
Phone (413) 447-2695

725 N Street Berkshire OB/GYN of
Mbu
Pittsfield, MA 01201-4109
Phone (413) 499-8570

780 S Main St
Suite 2
Great Barrington, MA 01230-2149
Phone (413) 447-2498

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
295996-1205UTMDCardiovascular Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Commonwealth Healthcare Corporation CurrentSince Jul 30, 2018 Accepting new patients
Berkshire Faculty Services Inc CurrentSince Sep 16, 2019 Accepting new patients
Commonwealth Healthcare Corporation CurrentSince Jul 30, 2018 Accepting new patients
Fairview Hospital CurrentSince Sep 16, 2019 Accepting new patients
Mountainstar Cardiology St Marks LLC Interventional Cardiology Past Accepting new patients
Ogden Reg Med CNTR Professional Billing LLC Cardiovascular Disease Past Accepting new patients

Locations

780 S Main St
Ste 2
Gt Barrington, MA 01230
Phone (413) 447-2498

725 North St
Pittsfield, MA 01201
Phone (413) 447-2839

Interoperability endpoints

  • Direct secure messaging: michaeldiehl@bfs.medalliesdirect.net

Organizations & group practices 6

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.

Hospital & facility affiliations 5

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1126656000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1421712000000",
    "number": "1265427371",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "520 MEDICAL DR",
            "address_2": "SUITE #310",
            "city": "BOUNTIFUL",
            "state": "UT",
            "postal_code": "840104968",
            "telephone_number": "801-397-3000",
            "fax_number": "801-397-0455"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5405 S 500 E",
            "address_2": "SUITE #204",
            "city": "OGDEN",
            "state": "UT",
            "postal_code": "844056957",
            "telephone_number": "801-479-0184",
            "fax_number": "801-479-5642"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIEHL",
        "first_name": "MICHAEL",
        "middle_name": "J",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-14",
        "last_updated": "2015-01-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "UT",
            "license": "295996-1205",
            "primary": false
        },
        {
            "code": "207RI0011X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": "UT",
            "license": "295996-1205",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP NPI",
            "identifier": "1477643179",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ogden, UT

Sources for this page

Verify at the official NPI Registry.