Timothy Ross Diestelkamp, MD

Primary specialty

Diagnostic Radiology PhysicianTaxonomy code 2085R0202X

License

72505 Issued in AZ

Practice address

4302 E Whitton Ave
Phoenix, AZ 85018-5944

Phone

(251) 680-6451

NPI assigned

Apr 2, 2018

Sex

Male

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 NY, AZ, CA3 enrollments

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 3

Specialty

Diagnostic Radiology

Education

Cooper Medical School of Rowan University, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Sonoran Radiology LTDGroup PAC ID 3375964505, 466 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Honorhealth Deer Valley Medical Center Hospital, Phoenix, AZ, CCN 030092
• Honorhealth Scottsdale Osborn Medical Center Hospital, Scottsdale, AZ, CCN 030038
• Honorhealth Scottsdale Shea Medical Center Hospital, Scottsdale, AZ, CCN 030087
• Honor Health John C. Lincoln Medical Center Hospital, Phoenix, AZ, CCN 030014
• Honorhealth Scottsdale Thompson Peak Med Ctr Hospital, Scottsdale, AZ, CCN 030123

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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 and National Provider Directory roles.

• Sonoran Radiology LTD

  • Vascular & Interventional Radiology Physician
  • Mesa, AZ
  • NPI 1033745708

  CA, Diagnostic Radiology, NY

  Medicare reassignment Care Compare group NPD
• Southwest Diagnostic Imaging LLC

  • Diagnostic Radiology Physician
  • Scottsdale, AZ
  • NPI 1902896236

  CA

  Medicare reassignment

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

• Honorhealth

  • General Acute Care Hospital
  • Scottsdale, AZ
  • NPI 1386608859
  Care Compare affiliation
• Honorhealth

  • General Acute Care Hospital
  • Scottsdale, AZ
  • NPI 1417152745
  Care Compare affiliation
• Honorhealth

  • General Acute Care Hospital
  • Phoenix, AZ
  • NPI 1528169125
  Care Compare affiliation
• Honorhealth

  • General Acute Care Hospital
  • Phoenix, AZ
  • NPI 1770690695
  Care Compare affiliation
• Honorhealth

  • General Acute Care Hospital
  • Scottsdale, AZ
  • NPI 1811951429
  Care Compare affiliation

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

{
    "created_epoch": "1522627200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714348800000",
    "number": "1861998635",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4302 E WHITTON AVE",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850185944"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4302 E WHITTON AVE",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850185944",
            "telephone_number": "251-680-6451"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIESTELKAMP",
        "first_name": "TIMOTHY",
        "middle_name": "ROSS",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-04-02",
        "last_updated": "2024-04-29",
        "certification_date": "2024-04-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "AZ",
            "license": "72505",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Abby Dierks
• Melinda Dierks
• Diersing Audiology Corp PC
• Lindsey Anne Dies, LPC
• Suzanne Diesel
• Laura E Dietrich-Lake, FNP-C
• Aryanna Dietz
• Mark Dietzgen, NMD
• Haley M Dietzman
• Ladon Dieu, RN

• Diagnostic Radiology Physician in Phoenix, AZ
• Providers in Phoenix, AZ by specialty
• Diagnostic Radiology Physician in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 2024; 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.