Individual provider Active NPI

Erik Stuart Diebolt, D.O.

  • Physical Medicine & Rehabilitation Physician
  • Austin, TX
National Provider Identifier
1386901072
Registry record updated Feb 9, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
License
R7708 Issued in TX
Practice address
12221 N Mopac Expy
Austin, TX 78758-2401
Phone
(512) 901-4011
Fax
(512) 901-3950
NPI assigned
Apr 18, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 9, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation Physician 208100000X 17618 NH
Physical Medicine & Rehabilitation Physician 208100000X R7708 TX Primary

Addresses

Primary practice location

12221 N Mopac Expy
Austin, TX 78758-2401

Mailing address

12221 N Mopac Expy
Austin, TX 78758-2401
Phone (512) 901-4011

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address ERIK.DIEBOLT@hca8.eclinicaldirectplus.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190530000221 TX Practitioner - Physical Medicine and Rehabilitation 7214248392 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Medicine and Rehabilitation
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
The Austin Diagnostic Clinic PLLCGroup PAC ID 1254244551, 87 clinicians

Practice addresses (Care Compare)

1201 W Louis Henna Blvd
Austin, TX 78681-2301
Phone (512) 248-7000

12221 N Mopac Expy
Austin, TX 78758-2401
Phone (512) 901-2530

12221 N Mopac Expy
Department of Laboratory Services
Austin, TX 78758-2483
Phone (512) 901-1111

1330 Wonder World Dr
Suite 101
San Marcos, TX 78666-7567
Phone (512) 805-0680

3000 N Interstate 35
Suite 708
Austin, TX 78705-1860
Phone (512) 901-4011

Hospital & facility affiliations

  • North Austin Medical Center Hospital, Austin, TX, CCN 450809
  • Peterson Regional Medical Center Hospital, Kerrville, TX, CCN 450007
  • Baylor Scott & White Institute for Rehabilitation Inpatient rehabilitation facility, Lakeway, TX, CCN 673058

Merit-based Incentive Payment System (MIPS)

Final score
81.41 of 100Reported as group
Quality
64.52
Promoting interoperability
100
Improvement activities
40
Cost
73.52

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
17618NHMDPhysical Medicine & Rehabilitation Physician
R7708TXMDPhysical Medicine & Rehabilitation Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Austin Diagnostic Clinic CurrentSince Feb 6, 2019 Accepting new patients
The Austin Diagnostic Clinic, PLLC CurrentSince Feb 6, 2019 Accepting new patients
Austin Diagnostic Clinic, PA Past Accepting new patients

Locations

2000 Health Park Dr
Brentwood, TN 37027
Phone (615) 372-5426

12221 N Mopac Expy
Austin, TX 78758
Phone (512) 901-2530

4315 James Casey St
Austin, TX 78745
Phone (512) 460-3404

1330 Wonder World Dr
Ste 101
San Marcos, TX 78666
Phone (512) 805-0680

Interoperability endpoints

  • Direct secure messaging: 11226-volpe-joe@direct.leadingreach.com
  • Direct secure messaging: erik.diebolt@hca8.eclinicaldirectplus.com
  • Direct secure messaging: 11226-diebolt-erik@direct.leadingreach.com
  • Direct secure messaging: ediebolt@concordo1403.srs-direct.com

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": "1334707200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1644364800000",
    "number": "1386901072",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12221 N MOPAC EXPY",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787582401",
            "telephone_number": "512-901-4011",
            "fax_number": "512-901-3950"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12221 N MOPAC EXPY",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787582401",
            "telephone_number": "512-901-4011",
            "fax_number": "512-901-3950"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIEBOLT",
        "first_name": "ERIK",
        "middle_name": "STUART",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-04-18",
        "last_updated": "2022-02-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "NH",
            "license": "17618",
            "primary": false
        },
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "TX",
            "license": "R7708",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ERIK.DIEBOLT@hca8.eclinicaldirectplus.com",
            "affiliation": "N",
            "address_1": "12221 N Mopac Expy",
            "city": "Austin",
            "state": "TX",
            "country_code": "US",
            "postal_code": "787582401",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Austin, TX

Sources for this page

Verify at the official NPI Registry.