NPIMap

Individual provider Active NPI

Melody Dieckman, PA-C

  • Medical Physician Assistant
  • Plymouth Meeting, PA
National Provider Identifier
1629856257
Registry record updated Jul 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
OA006810 Issued in PA
Practice address
2901 Jolly Rd
Plymouth Meeting, PA 19462-2324
Phone
(610) 272-8221
NPI assigned
Sep 15, 2023
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 9, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X
Medical Physician Assistant 363AM0700X OA006810 PA Primary

Addresses

Primary practice location

2901 Jolly Rd
Plymouth Meeting, PA 19462-2324

Mailing address

86-6 Ferne Blvd
Drexel Hill, PA 19026-5464

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ, PA2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20240307004169 NJ Practitioner - Physician Assistant 0840636288 Reassigns benefits to 1 organization
I20240620001494 PA Practitioner - Physician Assistant 0840636288 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2023
Medicare assignment
May accept Medicare assignment
Group practices
H2 Rehabilitation Extension Services LLCGroup PAC ID 6406131622, shared by 5 NPIs, 161 clinicians
Suburban Geriatric'S, Inc.Group PAC ID 4486551371, 102 clinicians
Suburban Geriatrics II PCGroup PAC ID 9537552419, 107 clinicians
Violet Valley Long Term Care PCGroup PAC ID 9638683915, 55 clinicians

Practice addresses (Care Compare)

137 Montgomery Ave
Boyertown, PA 19512-1300
Phone (484) 658-3150

2901 Jolly Rd
Plymouth Meeting, PA 19462-2324
Phone (610) 272-8221

Hospital & facility affiliations

  • Accentcare Home Health of Central Pennsylvania Home health agency, Elizabethtown, PA, CCN 398062
  • Reading Hospital Hospital, West Reading, PA, CCN 390044

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
OA006810PAMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Violet Valley Long Term Care PC CurrentSince Aug 18, 2025 Accepting new patients

Locations

2901 Jolly Rd
Plymouth Mtng, PA 19462
Phone (610) 272-3222

Organizations & group practices 5

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.

Hospital & facility affiliations 7

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

NPI Registry JSON

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

{
    "created_epoch": "1694736000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1720483200000",
    "number": "1629856257",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "86-6 FERNE BLVD",
            "city": "DREXEL HILL",
            "state": "PA",
            "postal_code": "190265464"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2901 JOLLY RD",
            "city": "PLYMOUTH MEETING",
            "state": "PA",
            "postal_code": "194622324",
            "telephone_number": "610-272-8221"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIECKMAN",
        "first_name": "MELODY",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-09-15",
        "last_updated": "2024-07-09",
        "certification_date": "2024-07-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "PA",
            "license": "OA006810",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Plymouth Meeting, PA

Sources for this page

Verify at the official NPI Registry.