Erin Marie Diedrick, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

Practice address

5045 W Grande Market Dr
Appleton, WI 54913-8517

Phone

(715) 460-0488

NPI assigned

Jun 1, 2017

Last updated

Jul 21, 2022By the provider in NPPES

Sex

Female

Sole proprietor

No

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 WI

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Ascension Medical Group-Fox Valley Wisconsin, IncGroup PAC ID 0244142420, shared by 2 NPIs, 260 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Ascension NE Wisconsin - St Elizabeth Campus Hospital, Appleton, WI, CCN 520009

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Ascension Medical Group-Fox Valley Wisconsin, Inc

  dba Ascension Medical Group

  • Multi-Specialty Clinic/Center
  • Neenah, WI
  • NPI 1730126392
  Medicare reassignment NPD
• Ascension Medical Group-Fox Valley Wisconsin, Inc

  • Cardiovascular Disease Physician
  • Appleton, WI
  • NPI 1831890177
  Medicare reassignment NPD
• Heart and Vascular of Wisconsin, SC

  dba Heart and Vascular Institute of Wisconsin

  • Cardiovascular Disease Physician
  • Appleton, WI
  • NPI 1053884478
  Medicare reassignment

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

• Ascension NE Wisconsin, Inc

  • Ambulatory Surgical Clinic/Center
  • Menasha, WI
  • NPI 1124075536

  Hospital

  Care Compare affiliation
• Ascension NE Wisconsin, Inc

  dba Ascension NE Wisconsin-St Elizabeth Campus

  • General Acute Care Hospital
  • Appleton, WI
  • NPI 1407803638
  Care Compare affiliation

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

{
    "created_epoch": "1496275200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1467980540",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5045 W GRANDE MARKET DR",
            "city": "APPLETON",
            "state": "WI",
            "postal_code": "549138517",
            "telephone_number": "715-460-0488"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5045 W GRANDE MARKET DR",
            "city": "APPLETON",
            "state": "WI",
            "postal_code": "549138517",
            "telephone_number": "715-460-0488"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "W8862 County Road F",
            "address_purpose": "LOCATION",
            "city": "Shiocton",
            "state": "WI",
            "postal_code": "541708704",
            "country_code": "US",
            "telephone_number": "715-460-0488",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1818 N Meade St",
            "address_purpose": "LOCATION",
            "city": "Appleton",
            "state": "WI",
            "postal_code": "549113454",
            "country_code": "US",
            "telephone_number": "920-731-4101",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DIEDRICK",
        "first_name": "ERIN",
        "middle_name": "MARIE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-06-01",
        "last_updated": "2022-07-21",
        "certification_date": "2020-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Matthew Dhein
• Stephanie N Diamond, LCSW
• Jose C Dias, MD
• Elizabeth Sue Dickenson, FNP-BC
• Danielle M Diedrich, LCSW
• Klair Diedrick
• Rebecca Diener
• Tam M Diep, DO
• Shanna Jay Dierker, FNP-BC
• Brenda Jeanne Dierschke, MD

• Physician Assistant in Appleton, WI
• Providers in Appleton, WI by specialty
• Physician Assistant in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.