Maryetta Dietz, CRNP

Primary specialty

Adult Health Nurse PractitionerTaxonomy code 363LA2200X

License

760224 Issued in TX

Practice address

1600 W 38TH St
Suite 308
Austin, TX 78731-6400

Phone

(512) 324-3540

Fax

(512) 324-3541

NPI assigned

Aug 9, 2006

Last updated

Jan 3, 2013By the provider in NPPES

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 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

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.

• Seton Family of Doctors

  • Neurological Surgery Physician
  • Austin, TX
  • NPI 1588997233
  NPD (past)
• University of Texas Medical Branch, Austin Initiatives at Utmb

  • Internal Medicine Physician
  • Austin, TX
  • NPI 1144393802
  NPD (past)

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

{
    "created_epoch": "1155081600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1357171200000",
    "number": "1316957582",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1400 N IH 35",
            "address_2": "SUITE 300",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787011926",
            "telephone_number": "512-324-8300",
            "fax_number": "512-324-8301"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1600 W 38TH ST",
            "address_2": "SUITE 308",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787316400",
            "telephone_number": "512-324-3540",
            "fax_number": "512-324-3541"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIETZ",
        "first_name": "MARYETTA",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-09",
        "last_updated": "2013-01-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "TX",
            "license": "760224",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "204269903",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "204269904",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "819N67",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jessica Bearden Dietert, M.D.
• Derek Dietrich, LPC
• Joseph D Dietrich, D.C.
• Pamela Dietrich, RN CPNP
• Matt Dietrichson
• T Hayden L Dietz, DO
• Brittany Joy Difabio, M.D.
• Charles R Difalco, MD
• Megan D Diggins, LVN
• Joy Diggs

• Adult Health Nurse Practitioner in Austin, TX
• Providers in Austin, TX by specialty
• Adult Health Nurse Practitioner in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 3, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.