Dirk Ross Diefendorf, M.D.

Primary specialty

Sports Medicine (Neuromusculoskeletal Medicine) PhysicianTaxonomy code 204C00000X

License

G53558 Issued in CA

Practice address

101 S Ellsworth Ave
Suite 607
San Mateo, CA 94401-3956

Phone

(650) 347-0157

Fax

(650) 347-0566

NPI assigned

Sep 20, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

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

Specialty

Orthopedic Surgery

Education

Northwestern University Feinberg Medical School, 1983

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Hospital & facility affiliations

• Peninsula Medical Center Hospital, Burlingame, CA, CCN 050007

Merit-based Incentive Payment System (MIPS)

Final score

88.94 of 100Reported as individual

Quality

79.89

Promoting interoperability

100

Improvement activities

40

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: ddiefendorf45901@hisp.ehr.sutterhealth.org

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.

• Mills-Peninsula Health Services

  • General Acute Care Hospital
  • Burlingame, CA
  • NPI 1518937051
  NPD (past)
• Palo Alto Medical Foundation

  • Non-Pharmacy Dispensing Site
  • Santa Cruz, CA
  • NPI 1114182649
  NPD (past)
• Sutter Bay Hospitals

  • General Acute Care Hospital
  • Burlingame, CA
  • NPI 1043670334
  NPD (past)
• Sutter East Bay Medical Foundation

  • Family Medicine Physician
  • Orinda, CA
  • NPI 1871538769
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Sutter Bay Hospitals

  • General Acute Care Hospital
  • Burlingame, CA
  • NPI 1043670334
  Care Compare affiliation
• Sutter Bay Hospitals

  • General Acute Care Hospital
  • Menlo Park, CA
  • NPI 1295199701
  Care Compare affiliation

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

{
    "created_epoch": "1158710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1283126400000",
    "number": "1467559443",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 S ELLSWORTH AVE",
            "address_2": "SUITE 607",
            "city": "SAN MATEO",
            "state": "CA",
            "postal_code": "944013956",
            "telephone_number": "650-347-0157",
            "fax_number": "650-347-0566"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 S ELLSWORTH AVE",
            "address_2": "SUITE 607",
            "city": "SAN MATEO",
            "state": "CA",
            "postal_code": "944013956",
            "telephone_number": "650-347-0157",
            "fax_number": "650-347-0566"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIEFENDORF",
        "first_name": "DIRK",
        "middle_name": "ROSS",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-20",
        "last_updated": "2010-08-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "204C00000X",
            "taxonomy_group": "",
            "desc": "Neuromusculoskeletal Medicine, Sports Medicine",
            "state": "CA",
            "license": "G53558",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Deborah Marie Diaz, LCSW
• Shannon Diaz
• Sonia Diaz
• Grace Patricia Dible, CNM
• Elizabeth Dickson
• Fred Arthur Diercks, DDS
• Paul Arthur Diercks, DDS
• Shelby Christin Diethelm
• Randy Ilanders Dillard, ACSW, MSW
• Valerie Diluggo, M.A.

• Sports Medicine (Neuromusculoskeletal Medicine) Physician in San Mateo, CA
• Providers in San Mateo, CA by specialty
• Sports Medicine (Neuromusculoskeletal Medicine) Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 30, 2010; 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.

Verify at the official NPI Registry.