Individual provider Active NPI

Anna Maureen Dieck, PA-C

  • Physician Assistant
  • Palo Alto, CA
National Provider Identifier
1386408631
Registry record updated Feb 7, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
64028 Issued in CA
Practice address
335 Lowell Ave
Palo Alto, CA 94301-3812
Phone
(650) 766-9247
NPI assigned
Feb 7, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 7, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 64028 CA Primary

Addresses

Primary practice location

335 Lowell Ave
Palo Alto, CA 94301-3812

Mailing address

335 Lowell Ave
Palo Alto, CA 94301-3812
Phone (650) 766-9247

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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

Enrollment IDStateProvider typePAC IDDetails
I20240618001927 CA Practitioner - Physician Assistant 1759824899 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
University of Pittsburgh School of Medicine, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
El Camino Health Medical Network LLCGroup PAC ID 6103115183, 202 clinicians

Practice addresses (Care Compare)

1150 W El Camino Real
Mountain View, CA 94040-2518
Phone (650) 988-7667

4150 N 1St St
San Jose, CA 95134-1513
Phone (408) 871-3400

625 Lincoln Ave
San Jose, CA 95126-3785
Phone (408) 871-3400

815 Pollard Rd
Los Gatos, CA 95032-1438
Phone (408) 866-4070

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
64028CAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
El Camino Health Medical Group Past Accepting new patients

Organizations & group practices 3

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.

Hospital & facility affiliations 3

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": "1707264000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707264000000",
    "number": "1386408631",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "335 LOWELL AVE",
            "city": "PALO ALTO",
            "state": "CA",
            "postal_code": "943013812",
            "telephone_number": "650-766-9247"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "335 LOWELL AVE",
            "city": "PALO ALTO",
            "state": "CA",
            "postal_code": "943013812",
            "telephone_number": "650-766-9247"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIECK",
        "first_name": "ANNA",
        "middle_name": "MAUREEN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-02-07",
        "last_updated": "2024-02-07",
        "certification_date": "2024-02-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "64028",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Palo Alto, CA

Sources for this page

Verify at the official NPI Registry.