Active NPI
Joseph Anthony Dieterle Jr., D.O.
- Pediatrics Physician
- Oxford, MD
National Provider Identifier
1467475202
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- H0060132
- Practice address
- 112 First St.
Oxford, MD 21654-0532 - Phone
- (410) 226-0013
- Fax
- (410) 226-0013
- NPI assigned
- Jul 25, 2006
- Last updated
- Dec 2, 2015
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | H0060132 | MD | Primary |
Addresses
Primary practice location
112 First St.
Oxford, MD 21654-0532
Mailing address
Box 532
112 First St.
Oxford, MD 21654-0532
Phone (410) 226-0013
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2290502 | Medicaid | NJ |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| H0060132 | MD | MD | Pediatrics Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Chop Clinical Associates, Inc | Pediatrics | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
dba Care Network Somers Point
- Pediatrics Physician
- Somers Point, NJ
- NPI 1619057437
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1153785600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1449014400000",
"number": "1467475202",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "BOX 532",
"address_2": "112 FIRST ST.",
"city": "OXFORD",
"state": "MD",
"postal_code": "216540532",
"telephone_number": "410-226-0013",
"fax_number": "410-226-0013"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "112 FIRST ST.",
"city": "OXFORD",
"state": "MD",
"postal_code": "216540532",
"telephone_number": "410-226-0013",
"fax_number": "410-226-0013"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DIETERLE",
"first_name": "JOSEPH",
"middle_name": "ANTHONY",
"name_prefix": "Dr.",
"name_suffix": "Jr.",
"credential": "D.O.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-07-25",
"last_updated": "2015-12-02",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "MD",
"license": "H0060132",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "2290502",
"state": "NJ"
}
],
"endpoints": [],
"other_names": []
}Other providers in Oxford, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.