Daniel John Dieterichs, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

390 Issued in NM

Practice address

3701 Eubank Blvd NE
Albuquerque, NM 87111-3536

Phone

(505) 298-2020

NPI assigned

Aug 10, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 6

Medicare fee-for-service enrollment

Enrolled in NM

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Albuquerque Associates of Optometry

  • Optometrist
  • Albuquerque, NM
  • NPI 1114058005
  Medicare reassignment NPD
• Albuquerque Associates of Optometry

  • Optometrist
  • Albuquerque, NM
  • NPI 1912182932
  NPD (past)

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

{
    "created_epoch": "1155168000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1582675200000",
    "number": "1407867245",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1606 JACK NICKLAUS DR",
            "city": "BELEN",
            "state": "NM",
            "postal_code": "870025925",
            "telephone_number": "505-450-5343"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3701 EUBANK BLVD NE",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871113536",
            "telephone_number": "505-298-2020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIETERICHS",
        "first_name": "DANIEL",
        "middle_name": "JOHN",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-10",
        "last_updated": "2020-02-26",
        "certification_date": "2020-02-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NM",
            "license": "390",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PRESBYTERIAN NEW MEXICO",
            "identifier": "201014237",
            "state": "NM"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE GROUP",
            "identifier": "DA6066",
            "state": "NM"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE INDIVID",
            "identifier": "410049648",
            "state": "NM"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DMERC",
            "identifier": "4991500001",
            "state": "NM"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS AND BLUE SHIEL",
            "identifier": "NM00P502",
            "state": "NM"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000E8983",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Diego J Gonzalez MD PC
• Sean M Diener, NP
• Kathy Dieruf, PT
• Elizabeth Diesel, LMSW
• Timothy Sean Diesel, DOM, PA-C
• Dietitiansabq
• Charles Dietl, MD
• Matthias A Dietrich
• Christine Dietz, PT
• Dale D. Dietz, LCSW

• Optometrist in Albuquerque, NM
• Providers in Albuquerque, NM by specialty
• Optometrist in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 26, 2020; 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.