Melissa a Dietz, MD, LLC

Primary specialty

Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X

License

24521 Issued in OK

Legal business name

MELISSA A DIETZ, MD, LLC

Practice address

1725 E 19TH St
Suite 401
Tulsa, OK 74104-5437

Phone

(918) 749-1413

Fax

(918) 749-0234

NPI assigned

Jan 5, 2015

Organization subpart

No

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

Authorized official

Name

Melissa A Dietz, MDNPI 1558581116

Title

Managing Member

Phone

(918) 749-1413

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in OK

Enrollment records 1

Member organizations 1

Organizations listed as members of this organization in the National Provider Directory.

• Utica Women'S Specialists, LLC

  • Obstetrics & Gynecology Physician
  • Tulsa, OK
  • NPI 1760918122

  Member Of

  NPD member

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Melissa Ann Dietz, M.D.

  • Obstetrics & Gynecology Physician
  • Tulsa, OK
  • NPI 1558581116
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1420416000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1657497600000",
    "number": "1285022939",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1725 E 19TH ST STE 401",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741045409",
            "telephone_number": "918-749-1413",
            "fax_number": "918-749-0234"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1725 E 19TH ST",
            "address_2": "SUITE 401",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741045437",
            "telephone_number": "918-749-1413",
            "fax_number": "918-749-0234"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MELISSA A DIETZ, MD, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-01-05",
        "last_updated": "2022-07-11",
        "certification_date": "2022-07-11",
        "status": "A",
        "authorized_official_last_name": "DIETZ",
        "authorized_official_first_name": "MELISSA",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "MANAGING MEMBER",
        "authorized_official_telephone_number": "918-749-1413",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Obstetrics & Gynecology",
            "state": "OK",
            "license": "24521",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200567150A",
            "state": "OK"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200125470A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Melanie R. Blackstock, M.D., Inc.
• Jasmine Melchior, LMFT CANDIDATE
• Ronda Melchiorre, LPC CANDIDATE
• Amaya Melendez
• Joana Melendez
• Sandra Marie Mellor, DNP, APPN, FNP-BC
• Sarah Melone
• Autumn Kara Meloy, RN
• Adrian Jade Melton-Williams
• Debby Ann Melton, MSW

• Obstetrics & Gynecology Physician in Tulsa, OK
• Providers in Tulsa, OK by specialty
• Obstetrics & Gynecology Physician in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 11, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.