David Michael Deitz, MD

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

MD00025585 Issued in WA

Practice address

3920 Capitol Mall Dr SW
Suite 302
Olympia, WA 98502-8700

Phone

(360) 754-3507

Fax

(360) 236-1457

NPI assigned

May 9, 2006

Last updated

Mar 7, 2008By 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

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1147132800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1204848000000",
    "number": "1336198118",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 9532",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "98409",
            "telephone_number": "360-491-5999",
            "fax_number": "360-491-5946"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3920 CAPITOL MALL DR SW",
            "address_2": "SUITE 302",
            "city": "OLYMPIA",
            "state": "WA",
            "postal_code": "985028700",
            "telephone_number": "360-754-3507",
            "fax_number": "360-236-1457"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEITZ",
        "first_name": "DAVID",
        "middle_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-09",
        "last_updated": "2008-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "WA",
            "license": "MD00025585",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LABOR & INDUSTRY",
            "identifier": "115568",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1072552",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ghea Mae Tiping Degillo, DNP
• Henry L Degive, MD
• Stephanie Muyargas Degroff
• Eliza Deguzman, PHARMD
• Cornelis Dehart Jr., MD
• Andrew Dejesus, CNIM
• Carmella L Dejesus
• Kimberly Marie Delaney
• Jean Gant Delastrada, M.ED., M.A.
• Rachel Ann Delateur, LMHC, GMHS

• Surgery Physician in Olympia, WA
• Providers in Olympia, WA by specialty
• Surgery Physician in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2008; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.