Active NPI
Patricia A Dietzgen, D.O.
- Family Medicine Physician
- Denver, CO
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 0039586
- Practice address
- 10350 E Dakota Ave
Denver, CO 80247-1314 - Phone
- (303) 338-4545
- NPI assigned
- Nov 9, 2005
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 4031 | AZ | |
| Family Medicine Physician | 207Q00000X | 0039586 | CO | Primary |
Addresses
Primary practice location
10350 E Dakota Ave
Denver, CO 80247-1314
Mailing address
10350 E Dakota Ave
Denver, CO 80247-1314
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 026461 | Other | CO | KAISER COMMERCIAL NUMBER |
| 77058721 | Medicaid | CO | |
| P00311738 | Other | AZ | PALMETO GBA |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| SOAP URL | https://careepiceast.kp.org:14430/Interconnect-prodcom/wcf/epic.community.hie/xcpdrespondinggateways | Health Information Exchange (HIE) |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in AZ, UT, TX
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 3
Care Compare profile
Medicare Care Compare- Specialty
- Family Practice
- Education
- Other, 1998
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
3000 Lawrence St
Suite 101
Denver, CO 80205-3422
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4031 | AZ | MD | Clinical Psychologist |
| 0039586 | CO | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Cmdpn Medical Group of Washington P C | Family Medicine | Current | Accepting new patients |
| Cirrusmd Medical Group of Delaware, P.a. | Family Medicine | Current | Accepting new patients |
| Cmdpn Medical Group of Texas, P.a. | Family Medicine | Current | Accepting new patients |
| Daniela English DO LLC | Family Medicine | Past | Accepting new patients |
| Aspen Medical Care, PC | Family Medicine | Past | Accepting new patients |
Locations
11201 N Tatum Blvd
Ste 300
Phoenix, AZ 85028
Phone (480) 900-3556
3000 Lawrence St
#101
Denver, CO 80205
Phone (720) 996-0522
3000 Lawrence St
Ste 101
Denver, CO 80205
6844 Bardstown Rd
Louisville, KY 40291
Phone (216) 303-1265
865 State Route 33
Ste 3
Freehold, NJ 07728
Phone (424) 292-2923
Organizations & group practices 5
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.
-
- Family Medicine Physician
- Dallas, TX
- NPI 1174082150
-
- Family Medicine Physician
- Aspen, CO
- NPI 1154451367
-
- Family Medicine Physician
- Phoenix, AZ
- NPI 1679756274
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1131494400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1623024000000",
"number": "1467433177",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10350 E DAKOTA AVE",
"city": "DENVER",
"state": "CO",
"postal_code": "802471314"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10350 E DAKOTA AVE",
"city": "DENVER",
"state": "CO",
"postal_code": "802471314",
"telephone_number": "303-338-4545"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DIETZGEN",
"first_name": "PATRICIA",
"middle_name": "A",
"name_prefix": "Dr.",
"credential": "D.O.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2005-11-09",
"last_updated": "2021-06-07",
"certification_date": "2021-06-07",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "AZ",
"license": "4031",
"primary": false
},
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "CO",
"license": "0039586",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "KAISER COMMERCIAL NUMBER",
"identifier": "026461",
"state": "CO"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "77058721",
"state": "CO"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PALMETO GBA",
"identifier": "P00311738",
"state": "AZ"
}
],
"endpoints": [
{
"endpointType": "SOAP",
"endpointTypeDescription": "SOAP URL",
"endpoint": "https://careepiceast.kp.org:14430/Interconnect-prodcom/wcf/epic.community.hie/xcpdrespondinggateways",
"affiliation": "N",
"endpointDescription": "CAREQUALITY",
"use": "HIE",
"useDescription": "Health Information Exchange (HIE)",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "C-CDA",
"address_1": "10350 E Dakota Ave",
"city": "Denver",
"state": "CO",
"country_code": "US",
"postal_code": "802471314",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Denver, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 7, 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.