Paige Benten Diepenbrock, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

2021020950 Issued in MO

Practice address

17 Ronnies PLZ
Saint Louis, MO 63126-3552

Phone

(314) 843-2020

NPI assigned

Jun 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 MO

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Specialty

Optometry

Education

University of Missouri St Louis - School of Optometry, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Medical Eyecare LLCGroup PAC ID 3072859156, 4 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

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.

• Medical Eyecare, LLC

  • Optometrist
  • Saint Louis, MO
  • NPI 1518438266
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1623628800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1683676800000",
    "number": "1962070235",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17 RONNIES PLZ",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631263552",
            "telephone_number": "314-843-2020",
            "fax_number": "314-843-2021"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17 RONNIES PLZ",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631263552",
            "telephone_number": "314-843-2020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIEPENBROCK",
        "first_name": "PAIGE",
        "middle_name": "BENTEN",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-06-14",
        "last_updated": "2023-05-10",
        "certification_date": "2023-05-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MO",
            "license": "2021020950",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Constance B Diekman, RD
• Annette Lynn Diekmann, PTA
• David P Diemer, MD
• Kathryn M Diemer, MD
• Karen Faye Diemert, MSW, ACSW, LCSW
• Dierbergs Markets Inc
• Dierbergs Markets Inc
• Dierbergs Markets Inc
• Dierbergs Markets Inc
• Dierbergs Markets Inc

• Optometrist in Saint Louis, MO
• Providers in Saint Louis, MO by specialty
• Optometrist in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 10, 2023; 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.