Donald David Dietze Jr., MD

Primary specialty

Neurological Surgery PhysicianTaxonomy code 207T00000X

License

019033 Issued in LA

Practice address

29301 N Dixie Ranch Rd
Lacombe, LA 70445

Phone

(985) 871-4114

Fax

(985) 871-4130

NPI assigned

Feb 27, 2006

Last updated

Oct 1, 2015By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in LA

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

Specialty

Neurosurgery

Education

Louisiana State University School of Medicine in New Orleans, 1986

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Hospital & facility affiliations

• Our Lady of the Lake Surgical Hospital Hospital, Slidell, LA, CCN 190270

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: donald.dietze@3638.securemail.prognocis.com

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.

• Spine Innovations, LLC

  • Specialist
  • Lacombe, LA
  • NPI 1366973935
  Medicare reassignment NPD Authorized official
• Surgical Spine Specialists, LLC

  • Specialist
  • Lacombe, LA
  • NPI 1821291980
  NPD (past)
• The North Institute, Apmc

  • Physical Therapy Clinic/Center
  • Lacombe, LA
  • NPI 1427243989
  NPD (past)

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

• Lake Surgical Hospital Slidell, LLC

  dba Southern Surgical Hospital

  • General Acute Care Hospital
  • Slidell, LA
  • NPI 1821465576
  Care Compare affiliation

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

{
    "created_epoch": "1140998400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1443657600000",
    "number": "1316913635",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "29301 N DIXIE RANCH RD",
            "city": "LACOMBE",
            "state": "LA",
            "postal_code": "70445",
            "telephone_number": "985-871-4114",
            "fax_number": "985-871-4130"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "29301 N DIXIE RANCH RD",
            "city": "LACOMBE",
            "state": "LA",
            "postal_code": "70445",
            "telephone_number": "985-871-4114",
            "fax_number": "985-871-4130"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIETZE",
        "first_name": "DONALD",
        "middle_name": "DAVID",
        "name_suffix": "Jr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-27",
        "last_updated": "2015-10-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207T00000X",
            "taxonomy_group": "",
            "desc": "Neurological Surgery",
            "state": "LA",
            "license": "019033",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Compounding Corner Inc.
• Covington Physician Services LLC
• Crescent Imaging, LLC
• Arthur Evan Davies Jr., PT
• Dietze & Logan Spine Specialist, LLC
• Cori D. Dysart Gagnard, M.ED.
• Adjuan Edgerson, RN
• Brigitte Emanuel, LCSWR
• Emergency Group of Covington LLC
• Lorenzo Boykin Fisher, APRN, FNP-C

• Neurological Surgery Physician in Lacombe, LA
• Providers in Lacombe, LA by specialty
• Neurological Surgery Physician in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 2015; 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.