Dieter Fellner, DPM

Primary specialty

Foot Surgery PodiatristTaxonomy code 213ES0131X

License

0385 Issued in NH

Practice address

2 Broadway Ave
Gorham, NH 03581-1502

Phone

(603) 466-2741

NPI assigned

Mar 29, 2013

Last updated

Nov 23, 2022By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in NY, NH2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 2

Specialty

Podiatry

Education

Other, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Coos County Family Health Services IncGroup PAC ID 8628970480, 33 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Androscoggin Valley Hospital Hospital, Berlin, NH, CCN 301310

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Coos County Family Health Services, Inc

  • Federally Qualified Health Center (FQHC)
  • Berlin, NH
  • NPI 1346242054
  Medicare reassignment Care Compare group NPD
• Starrett Podiatry, LLC

  • Foot & Ankle Surgery Podiatrist
  • New York, NY
  • NPI 1952553372
  Medicare reassignment
• Coos County Family Health Services, Inc

  dba Coos County Family Health - Colebrook Site

  • Federally Qualified Health Center (FQHC)
  • Colebrook, NH
  • NPI 1659163434
  NPD
• Coos County Family Health Services, Inc

  • Federally Qualified Health Center (FQHC)
  • Gorham, NH
  • NPI 1275535999
  NPD (past)
• Foothurt Podiatry P.C.

  • Foot Surgery Podiatrist
  • New York, NY
  • NPI 1750779278
  NPD (past)

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

• Androscoggin Valley Hospital Inc

  dba AVH Surgical Associates

  • General Practice Physician
  • Berlin, NH
  • NPI 1679526644

  Hospital

  Care Compare affiliation
• Androscoggin Valley Hospital, Inc.

  • Critical Access Hospital
  • Berlin, NH
  • NPI 1386680593
  Care Compare affiliation

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

{
    "created_epoch": "1364515200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1669161600000",
    "number": "1316280282",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 BROADWAY AVE",
            "city": "GORHAM",
            "state": "NH",
            "postal_code": "035811502",
            "telephone_number": "603-466-2741"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 BROADWAY AVE",
            "city": "GORHAM",
            "state": "NH",
            "postal_code": "035811502",
            "telephone_number": "603-466-2741"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FELLNER",
        "first_name": "DIETER",
        "name_prefix": "Dr.",
        "credential": "DPM",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-03-29",
        "last_updated": "2022-11-23",
        "certification_date": "2022-11-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213ES0131X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot Surgery",
            "state": "NY",
            "license": "N006747",
            "primary": false
        },
        {
            "code": "213ES0131X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot Surgery",
            "state": "NH",
            "license": "0385",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Elaine Carol Davis, LCMHC/LADC
• Kathleen Donovan, MD
• Dummer School District
• Derek C Eastman, PT, DPT
• Errol School District
• Grazyna Galicka-Piskorska, MD
• Amy Lynn Galipeau, HIS
• Kimberly Gallant, PAC
• William Jay Gessner, MD
• Jameson Giamo, HIS

• Foot Surgery Podiatrist in Gorham, NH
• Providers in Gorham, NH by specialty
• Foot Surgery Podiatrist in New Hampshire

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 23, 2022; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.