Katie Marie Dienell, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA9117206 Issued in FL

Practice address

160 NW 170TH St
North Miami Beach, FL 33169-5521

Phone

(305) 651-1100

NPI assigned

Aug 21, 2009

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

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.

• Katie Dienell Pac LLC

  • Medical Specialty Clinic/Center
  • Saint Louis, MO
  • NPI 1184560575
  NPD

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

{
    "created_epoch": "1250812800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706572800000",
    "number": "1902038144",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "160 NW 170TH ST",
            "city": "NORTH MIAMI BEACH",
            "state": "FL",
            "postal_code": "331695521",
            "telephone_number": "314-362-9123"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "160 NW 170TH ST",
            "city": "NORTH MIAMI BEACH",
            "state": "FL",
            "postal_code": "331695521",
            "telephone_number": "305-651-1100"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "400 S Kingshighway Blvd",
            "address_purpose": "LOCATION",
            "city": "Saint Louis",
            "state": "MO",
            "postal_code": "631101014",
            "country_code": "US",
            "telephone_number": "314-362-9123",
            "fax_number": "314-747-3338",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DIENELL",
        "first_name": "KATIE",
        "middle_name": "MARIE",
        "name_prefix": "Ms.",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-08-21",
        "last_updated": "2024-01-30",
        "certification_date": "2024-01-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9117206",
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MO",
            "license": "2016044080",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lia Jose Diaz
• Marco Antonio Diaz, MA
• Michelle Diaz, PHARMD
• Pedro Joaquin Diaz, M.D.
• Anthony Jose Dieguez, DO
• Kim Mara Dierickx, PA
• Lisandra Diez Espinosa
• Evanna Doble
• Doh Homecare Inc
• Donald E. Johnson, MD, PA

• Physician Assistant in North Miami Beach, FL
• Providers in North Miami Beach, FL by specialty
• Physician Assistant in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.