Individual provider Active NPI

Kathleen E Dieckmann, MD

  • Family Medicine Physician
  • Brunswick, ME
National Provider Identifier
1386177780
Registry record updated Jul 20, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MD26163 Issued in ME
Practice address
123 Medical Center Dr
Brunswick, ME 04011-2652
Phone
(207) 373-6000
NPI assigned
Apr 4, 2017
Last updated
Jul 20, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 20, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X MD26163 ME Primary

Addresses

Primary practice location

123 Medical Center Dr
Brunswick, ME 04011-2652

Mailing address

123 Medical Center Dr
Brunswick, ME 04011-2652
Phone (207) 373-6000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ME
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 1

Enrollment IDStateProvider typePAC IDDetails
I20220830003499 ME Practitioner - Hospitalist 4688007636 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Hospitalist
Education
University of Louisville School of Medicine, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
MainehealthGroup PAC ID 7517860588, 2,616 clinicians

Practice addresses (Care Compare)

22 Bramhall St
Portland, ME 04102-3134
Phone (207) 885-9905

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
86.22 of 100Reported as group
Quality
75.39
Promoting interoperability
84
Improvement activities
40
Cost
75.32

Merit-based Incentive Payment System (MIPS)

Final score
97.93 of 100Reported as apm
Quality
83.31
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Mainehealth CurrentSince Aug 22, 2022 Accepting new patients
Mainegeneral Medical Center CurrentSince Mar 5, 2024 Accepting new patients
Mainegeneral Medical Center CurrentSince Mar 5, 2024 Accepting new patients
Mainehealth CurrentSince Aug 22, 2022 Accepting new patients
Mainehealth Current Accepting new patients
Mainehealth Past Accepting new patients

Locations

35 Medical Center Pkwy
Augusta, ME 04330
Phone (207) 621-3639

123 Medical Center Dr
Brunswick, ME 04011
Phone (207) 373-6800

22 Bramhall St
Portland, ME 04102
Phone (207) 662-2179

149 North St
Waterville, ME 04901
Phone (207) 622-1959

Interoperability endpoints

  • Direct secure messaging: kdieckmann296119@direct.mmc.mainehealth.org

Organizations & group practices 6

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.

Hospital & facility affiliations 1

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

NPI Registry JSON

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

{
    "created_epoch": "1491264000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658275200000",
    "number": "1386177780",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "123 MEDICAL CENTER DR",
            "city": "BRUNSWICK",
            "state": "ME",
            "postal_code": "040112652",
            "telephone_number": "207-373-6000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "123 MEDICAL CENTER DR",
            "city": "BRUNSWICK",
            "state": "ME",
            "postal_code": "040112652",
            "telephone_number": "207-373-6000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIECKMANN",
        "first_name": "KATHLEEN",
        "middle_name": "E",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-04-04",
        "last_updated": "2022-07-20",
        "certification_date": "2022-07-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "ME",
            "license": "MD26163",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brunswick, ME

Sources for this page

Verify at the official NPI Registry.