Lisa Dietz, DO

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

LD011820 Issued in MI

Practice address

6507 Town Center Dr
Suite a
Clarkston, MI 48346-4826

Phone

(248) 922-9975

Fax

(248) 922-9143

NPI assigned

Oct 14, 2005

Last updated

Feb 19, 2013By 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

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MI

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

Internal Medicine

Education

College of Osteo Med of the Pacific at Pomona, 1992

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

McLaren Medical GroupGroup PAC ID 3971416082, 240 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Elara Caring Home health agency, Jackson, MI, CCN 237274
• McLaren Oakland Hospital, Pontiac, MI, CCN 230207
• McLaren Flint Hospital, Flint, MI, CCN 230141
• Trinity Health Oakland Hospital Hospital, Pontiac, MI, CCN 230029
• Ascension Providence Rochester Hospital Hospital, Rochester, MI, CCN 230254

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

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.

• McLaren Medical Group

  • Family Medicine Physician
  • Lapeer, MI
  • NPI 1346396066
  Medicare reassignment Care Compare group NPD
• Lisa Dietz DO PLLC

  • Internal Medicine Physician
  • Clarkston, MI
  • NPI 1447445879
  NPD (past) Authorized official
• Hospital Health Care Inc.

  dba Clarkston Primary Care

  • Internal Medicine Physician
  • Pontiac, MI
  • NPI 1609970359

  Family Medicine

  NPD (past)
• McLaren Medical Group

  • Internal Medicine Physician
  • Flint, MI
  • NPI 1780652206

  Family Medicine

  NPD (past)
• Lima Memorial Joint Operating Company

  dba Lima Memorial Health System

  • General Acute Care Hospital
  • Lima, OH
  • NPI 1336144732
  NPD (past)

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

• Great Lakes Home Health Services, Inc.

  dba Elara Caring

  • Home Health Agency
  • Jackson, MI
  • NPI 1588642110
  Care Compare affiliation
• Henry Ford Health Rochester Hospital

  • General Acute Care Hospital
  • Rochester, MI
  • NPI 1437176203
  Care Compare affiliation
• McLaren Flint

  • General Acute Care Hospital
  • Flint, MI
  • NPI 1902894512
  Care Compare affiliation
• McLaren Oakland

  • General Acute Care Hospital
  • Pontiac, MI
  • NPI 1376564088
  Care Compare affiliation
• St Joseph Mercy Hospital-SMHC

  dba St Joseph Mercy Oakland

  • General Acute Care Hospital
  • Pontiac, MI
  • NPI 1053356352
  Care Compare affiliation

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

{
    "created_epoch": "1129248000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1361232000000",
    "number": "1629067541",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6507 TOWN CENTER DR",
            "address_2": "SUITE A",
            "city": "CLARKSTON",
            "state": "MI",
            "postal_code": "483464826",
            "telephone_number": "248-922-9975",
            "fax_number": "248-922-9143"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6507 TOWN CENTER DR",
            "address_2": "SUITE A",
            "city": "CLARKSTON",
            "state": "MI",
            "postal_code": "483464826",
            "telephone_number": "248-922-9975",
            "fax_number": "248-922-9143"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIETZ",
        "first_name": "LISA",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-10-14",
        "last_updated": "2013-02-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "LD011820",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4225528",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kaitlin Dickerson
• Phoebe Dickman, M.ED., BCBA
• George Stehpen Didur, RPH
• Ashley Dieckmann
• Christina Diederichs, LMSW, CAADC
• Dignitas Vitae Home Care LLC
• Brittany Nicole Dimaria, RBT
• Madison Monique Diton
• Savannah Marie Dodson, BEHAVIOR TECHNICIAN
• Donald K Nanney DDS PC

• Family Medicine Physician in Clarkston, MI
• Providers in Clarkston, MI by specialty
• Family Medicine Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 2013; 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.