Jennifer Lynne Dietzel, NP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

4704261791 Issued in MI

Practice address

3023 Davenport Ave
Saginaw, MI 48602-3652

Phone

(989) 907-2761

Fax

(989) 907-2762

NPI assigned

Nov 15, 2013

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

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in MI

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2013

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Great Lakes Bay Health CentersGroup PAC ID 2466369046, 85 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: jennifer.dietzel.1@27771.direct.athenahealth.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Great Lakes Bay Health Centers

  • Obstetrics & Gynecology Physician
  • Saginaw, MI
  • NPI 1871684761
  Medicare reassignment Care Compare group
• Great Lakes Bay Health Centers

  • Federally Qualified Health Center (FQHC)
  • Saginaw, MI
  • NPI 1629171707
  NPD (past)

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

{
    "created_epoch": "1384473600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1664755200000",
    "number": "1376973073",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3023 DAVENPORT AVE",
            "city": "SAGINAW",
            "state": "MI",
            "postal_code": "486023652",
            "fax_number": "989-399-8233"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3023 DAVENPORT AVE",
            "city": "SAGINAW",
            "state": "MI",
            "postal_code": "486023652",
            "telephone_number": "989-907-2761",
            "fax_number": "989-907-2762"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIETZEL",
        "first_name": "JENNIFER",
        "middle_name": "LYNNE",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-11-15",
        "last_updated": "2022-10-03",
        "certification_date": "2022-10-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MI",
            "license": "4704261791",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jennifer.dietzel@direct.medfusion.com",
            "affiliation": "N",
            "address_1": "3023 Davenport Ave",
            "city": "Saginaw",
            "state": "MI",
            "country_code": "US",
            "postal_code": "486023652",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Salynda Diaz, LMSW
• Amy Dickhausen
• Janet Diefenbach
• Jennifer Dietrich
• Charles Milan Dietz
• Greta L. Dijak, P.T.
• Heidi Lynn Dijak, LMSW, CAADC
• Diligent Home Healthcare Services
• Corrine Collins Dill, FNP
• James E. Dillon, M.D.

• Nurse Practitioner in Saginaw, MI
• Providers in Saginaw, MI by specialty
• Nurse Practitioner in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 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.