Albert Joseph Dietz Jr., MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

39310-20 Issued in WI

Practice address

W651 West CT
Genoa City, WI 53128-1124

Phone

(262) 279-0722

NPI assigned

Oct 25, 2021

Last updated

Oct 25, 2021By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1635120000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1635120000000",
    "number": "1972267128",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "W651 WEST CT",
            "city": "GENOA CITY",
            "state": "WI",
            "postal_code": "531281124",
            "telephone_number": "262-279-0722"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "W651 WEST CT",
            "city": "GENOA CITY",
            "state": "WI",
            "postal_code": "531281124",
            "telephone_number": "262-279-0722"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIETZ",
        "first_name": "ALBERT",
        "middle_name": "JOSEPH",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-10-25",
        "last_updated": "2021-10-25",
        "certification_date": "2021-10-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "WI",
            "license": "39310-20",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nicholas A Batson, PT, DPT
• Aimee Blood, RN
• Brookwood School JT School Dist 2 (Genoa City Jt 2 School District)
• Burr Oak Manor, Inc.
• Sharon Lee Ehrlich, LPN
• Jennifer Ann Frisby
• Lucia G Garrity, R.N.
• Geneva Surgical Suites, LLC
• Genoa City Fyzical, LLC

• Internal Medicine Physician in Genoa City, WI
• Providers in Genoa City, WI by specialty
• Internal Medicine Physician in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.