Joseph R Deitz, M.D.

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

140668 Issued in AK

Practice address

122 1St Ave Ste 600
Fairbanks, AK 99701

Phone

(907) 452-8251

NPI assigned

Sep 30, 2008

Sex

Male

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Medicare fee-for-service enrollment

Enrolled in ME

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 1

Specialty

Psychiatry

Education

Other, 2008

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

State of MaineGroup PAC ID 7517875131, 19 clinicians

Practice addresses (Care Compare)

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.

• State of Maine

  dba Dorothea Dix Psychiatric Center

  • Psychiatric Hospital
  • Bangor, ME
  • NPI 1699776146
  Medicare reassignment Care Compare group NPD
• State of Maine

  dba Riverview Psychiatric Hospital

  • Psychiatric Hospital
  • Augusta, ME
  • NPI 1053319566
  NPD

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

{
    "created_epoch": "1222732800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1563494400000",
    "number": "1932350691",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "122 1ST AVE STE 600",
            "city": "FAIRBANKS",
            "state": "AK",
            "postal_code": "997014899",
            "telephone_number": "907-452-8251"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "122 1ST AVE STE 600",
            "city": "FAIRBANKS",
            "state": "AK",
            "postal_code": "99701",
            "telephone_number": "907-452-8251"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9981 S Healthpark Dr # 2-West",
            "address_purpose": "LOCATION",
            "city": "Fort Myers",
            "state": "FL",
            "postal_code": "33908",
            "country_code": "US",
            "telephone_number": "239-343-2062",
            "fax_number": "239-424-4186",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DEITZ",
        "first_name": "JOSEPH",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-09-30",
        "last_updated": "2019-07-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NY",
            "license": "262855-1",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "ME",
            "license": "MD19178",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "FL",
            "license": "ME118056",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "AK",
            "license": "140668",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jeanne Bamrick Debono, MD
• Elizabeth Easley Decker, PA-C
• Amy Decorso
• Kayleigh Davis Defoore, PA
• Porsche Dehut, APRN
• Caralyne Delaney, N.D.
• Dorothy S Delaney, ANP
• Brandon Evan Delkittie
• Michelle Lee Dellis
• Rhonda Deloatch

• Psychiatry Physician in Fairbanks, AK
• Providers in Fairbanks, AK by specialty
• Psychiatry Physician in Alaska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 2019; 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.