Heidi Dawn Dietl

Primary specialty

Massage TherapistTaxonomy code 225700000X

License

022165 Issued in NY

Practice address

234 Crossways Park Dr
Woodbury, NY 11797-2015

Phone

(516) 477-8003

NPI assigned

Jul 4, 2020

Last updated

Jul 4, 2020By the provider in NPPES

Sex

Female

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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.

• Renew Wellness Inc

  • Massage Therapist
  • Woodbury, NY
  • NPI 1366260473
  NPD Authorized official

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

{
    "created_epoch": "1593820800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1593820800000",
    "number": "1780201921",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "234 CROSSWAYS PARK DR",
            "city": "WOODBURY",
            "state": "NY",
            "postal_code": "117972015"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "234 CROSSWAYS PARK DR",
            "city": "WOODBURY",
            "state": "NY",
            "postal_code": "117972015",
            "telephone_number": "516-477-8003"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIETL",
        "first_name": "HEIDI",
        "middle_name": "DAWN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-07-04",
        "last_updated": "2020-07-04",
        "certification_date": "2020-07-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "NY",
            "license": "022165",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Juliana Nicole De Vito, M.S. CF-SLP
• Brooke Denner, LMHC
• Smina Desai
• Julie Desimone, D.M.D.
• Milagros Diaz, MD
• Cathy Distefano, OMT
• Jessica Dizinno
• Carolyn G Dombrowski, NPP
• Sarah Donohue, PA
• Dr Jill L Strominger, DC,PC

• Massage Therapist in Woodbury, NY
• Providers in Woodbury, NY by specialty
• Massage Therapist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 4, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.