Shelbi Diezel, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

10003422A Issued in IN

Practice address

479 Van Camp SQ
Greenwood, IN 46143-1616

Phone

(317) 694-6089

NPI assigned

Oct 14, 2021

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 IN

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, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Pic Indiana PCGroup PAC ID 3476790239, 143 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

90.99 of 100Reported as apm

Quality

77.41

Promoting interoperability

100

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

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.

• Pic Indiana PC

  • Urgent Care Clinic/Center
  • Mishawaka, IN
  • NPI 1942546890
  Medicare reassignment Care Compare group
• Physicians Immediate Care LTD

  • Urgent Care Clinic/Center
  • Rockford, IL
  • NPI 1528046323
  NPD (past)

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

{
    "created_epoch": "1634169600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1670803200000",
    "number": "1801559034",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "479 VAN CAMP SQ",
            "city": "GREENWOOD",
            "state": "IN",
            "postal_code": "461431616"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "479 VAN CAMP SQ",
            "city": "GREENWOOD",
            "state": "IN",
            "postal_code": "461431616",
            "telephone_number": "317-694-6089"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIEZEL",
        "first_name": "SHELBI",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-10-14",
        "last_updated": "2022-12-12",
        "certification_date": "2022-12-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IN",
            "license": "10003422A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Benjamin John Diekhoff, DDS
• Edward John Diekhoff, MD
• Emily Diekhoff
• Sharon Dietzer, RBT
• Shelley Kaluf Dieudonne, O.D.
• Digimax Medical LLC
• Digimax Medical LLC
• Mark J Dilella, DO
• Ryan Scott Dill, M.D.
• Stephanie Lynn Dille-Huggins, MA, BCBA

• Physician Assistant in Greenwood, IN
• Providers in Greenwood, IN by specialty
• Physician Assistant in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 12, 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.