Matthew Steven Dietz, D.O.

Primary specialty

Pediatric Hematology & Oncology PhysicianTaxonomy code 2080P0207X

License

11767382-1204 Issued in UT

Practice address

3181 SW Sam Jackson Park Rd
Portland, OR 97239-3011

Phone

(503) 494-8211

NPI assigned

Mar 21, 2013

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in UT

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: mdietz458179@direct.med.utah.edu

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.

• University of Utah Pediatric Services

  • Pediatrics Physician
  • Salt Lake City, UT
  • NPI 1487018974
  Medicare reassignment NPD
• University of Utah Pediatric Services

  • Pediatric Infectious Diseases Physician
  • Salt Lake City, UT
  • NPI 1285098855
  NPD
• University of Utah Pediatric Services

  • Pediatrics Physician
  • Salt Lake City, UT
  • NPI 1497116347
  NPD
• University of Utah Pediatric Services

  • Pediatrics Physician
  • Riverton, UT
  • NPI 1043671985
  NPD (past)

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

{
    "created_epoch": "1363824000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1639958400000",
    "number": "1386986909",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5150 SW LANDING",
            "address_2": "105",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972394414",
            "telephone_number": "860-841-7599"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3181 SW SAM JACKSON PARK RD",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972393011",
            "telephone_number": "503-494-8211"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIETZ",
        "first_name": "MATTHEW",
        "middle_name": "STEVEN",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-03-21",
        "last_updated": "2021-12-20",
        "certification_date": "2021-12-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "OR",
            "license": "DO176689",
            "primary": false
        },
        {
            "code": "2080P0207X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Hematology-Oncology",
            "state": "UT",
            "license": "11767382-1204",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "MDIETZ458179@DIRECT.MED.UTAH.EDU",
            "affiliation": "Y",
            "affiliationName": "University of Utah",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CDA/CCD/TXT",
            "address_1": "50 N Medical Dr",
            "city": "Salt Lake City",
            "state": "UT",
            "country_code": "US",
            "postal_code": "841320001",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Lacy Dietle
• Grace Ann Dietrich
• Mary K Dietrich, CNM
• Richard L Dietrich, D.M.D.
• Chelsie Justine Kalina Dietz, MD
• Jolie Rosanne Dietzen, CRNA
• Amanda Kristi Dieu, OD
• Sheilagh Diez
• Celia Frances Diffely
• Darren Digby

• Pediatric Hematology & Oncology Physician in Portland, OR
• Providers in Portland, OR by specialty
• Pediatric Hematology & Oncology Physician in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 20, 2021; 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.