M. Lyndon Dieter, MD

Primary specialty

Anesthesiology PhysicianTaxonomy code 207L00000X

License

MD60212924 Issued in WA

Practice address

801 E Wheeler Rd
Moses Lake, WA 98837-1899

Phone

(509) 765-5606

Fax

(509) 764-3244

NPI assigned

Nov 2, 2005

Last updated

Feb 17, 2022By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Other identifiers 6

Other names 1

• Dr. Mark Lyndon Dieter Other name

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in WA

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

Anesthesiology

Education

Other, 2007

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Grant County Public Hospital District 1Group PAC ID 9931095692, 112 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Samaritan Hospital Hospital, Moses Lake, WA, CCN 500033

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine, Physician Assistant

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

• Grant County Public Hospital District 1

  dba Samaritan Clinic

  • Rural Health Clinic/Center
  • Moses Lake, WA
  • NPI 1619086766
  Medicare reassignment Care Compare group NPD
• Grant County Public Hospital District 1

  dba Samaritan Clinic on Patton

  • Rural Health Clinic/Center
  • Moses Lake, WA
  • NPI 1609112739
  NPD
• Grant County Public Hospital District 1

  dba Samaritan

  • General Acute Care Hospital
  • Moses Lake, WA
  • NPI 1902818883
  NPD
• Grant County Public Hospital District 1

  dba Samaritan Hospitalist Group

  • Hospitalist Physician
  • Moses Lake, WA
  • NPI 1053981910
  NPD (past)
• Emergency Physician Professional Association, LTD.

  • Emergency Medicine Physician
  • Glendale, AZ
  • NPI 1396769972
  NPD (past)
• Emergency Physicians Professional Association LTD

  • Emergency Medicine Physician
  • Phoenix, AZ
  • NPI 1114931490
  NPD (past)
• Physician Anesthesia Associates, S.C.

  • Anesthesiology Physician
  • Elk Grove Village, IL
  • NPI 1376629550
  NPD (past)

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

• Grant County Public Hospital District 1

  dba Samaritan

  • General Acute Care Hospital
  • Moses Lake, WA
  • NPI 1902818883
  Care Compare affiliation

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

{
    "created_epoch": "1130889600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1645056000000",
    "number": "1508857103",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "660 S COOLIDGE ST",
            "city": "MOSES LAKE",
            "state": "WA",
            "postal_code": "988371872",
            "telephone_number": "509-793-9715",
            "fax_number": "509-764-3244"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "801 E WHEELER RD",
            "city": "MOSES LAKE",
            "state": "WA",
            "postal_code": "988371899",
            "telephone_number": "509-765-5606",
            "fax_number": "509-764-3244"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIETER",
        "first_name": "M.",
        "middle_name": "LYNDON",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-02",
        "last_updated": "2022-02-17",
        "certification_date": "2022-02-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "WA",
            "license": "MD60212924",
            "primary": true
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "IL",
            "license": "125.054676",
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "IL",
            "license": "036.124143",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "AZ",
            "license": "1452",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP HEALTH GRP #",
            "identifier": "453051001",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "EVERCARE GROUP #",
            "identifier": "3981220",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHNET GRP #",
            "identifier": "AW1436",
            "state": "AZ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "358566",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HUMANA GROUP #",
            "identifier": "860373636",
            "state": "AZ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2015006",
            "state": "WA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mdieter2028668@wm.providencedirect.org",
            "affiliation": "N",
            "endpointDescription": "EPIC EMR",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "801 E Wheeler Rd",
            "city": "Moses Lake",
            "state": "WA",
            "country_code": "US",
            "postal_code": "988371899",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "MARK",
            "last_name": "DIETER",
            "middle_name": "LYNDON",
            "prefix": "DR.",
            "credential": "MD",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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• Anesthesiology Physician in Moses Lake, WA
• Providers in Moses Lake, WA by specialty
• Anesthesiology Physician in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 17, 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.