Individual provider Active NPI

Dieter Kurt Thomas Schmidt, MD

  • MOHS-Micrographic Surgery Physician
  • Mill Creek, WA
National Provider Identifier
1982705158
Registry record updated Jan 29, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
MOHS-Micrographic Surgery PhysicianTaxonomy code 207ND0101X
License
MD00044310 Issued in WA
Practice address
15906 Mill Creek Blvd
Ste 105
Mill Creek, WA 98012-1603
Phone
(425) 385-2009
Fax
(425) 939-0807
NPI assigned
Sep 26, 2006
Last updated
Jan 29, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 29, 2021

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X MD00044310 WA
MOHS-Micrographic Surgery Physician 207ND0101X MD00044310 WA Primary
Dermatopathology Physician 207ND0900X MD00044310 WA
Pediatric Dermatology Physician 207NP0225X MD00044310 WA
Procedural Dermatology Physician 207NS0135X MD00044310 WA

Addresses

Primary practice location

15906 Mill Creek Blvd
Ste 105
Mill Creek, WA 98012-1603

Mailing address

1793 13TH St SE
Salem, OR 97302-2541
Phone (971) 273-1024

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
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

Enrollment IDStateProvider typePAC IDDetails
I20050815000621 WA Practitioner - Dermatology 6901836493

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
90.65 of 100Reported as group
Promoting interoperability
89
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MD00044310WAMDDermatopathology Physician

Interoperability endpoints

  • Direct secure messaging: dieters@frontierdermpartners.emadirect.md

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1159228800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1611878400000",
    "number": "1982705158",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1793 13TH ST SE",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973022541",
            "telephone_number": "971-273-1024",
            "fax_number": "503-362-8435"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15906 MILL CREEK BLVD",
            "address_2": "STE 105",
            "city": "MILL CREEK",
            "state": "WA",
            "postal_code": "980121603",
            "telephone_number": "425-385-2009",
            "fax_number": "425-939-0807"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHMIDT",
        "first_name": "DIETER",
        "middle_name": "KURT THOMAS",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-26",
        "last_updated": "2021-01-29",
        "certification_date": "2021-01-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "WA",
            "license": "MD00044310",
            "primary": false
        },
        {
            "code": "207ND0101X",
            "taxonomy_group": "",
            "desc": "Dermatology, MOHS-Micrographic Surgery",
            "state": "WA",
            "license": "MD00044310",
            "primary": true
        },
        {
            "code": "207ND0900X",
            "taxonomy_group": "",
            "desc": "Dermatology, Dermatopathology",
            "state": "WA",
            "license": "MD00044310",
            "primary": false
        },
        {
            "code": "207NP0225X",
            "taxonomy_group": "",
            "desc": "Dermatology, Pediatric Dermatology",
            "state": "WA",
            "license": "MD00044310",
            "primary": false
        },
        {
            "code": "207NS0135X",
            "taxonomy_group": "",
            "desc": "Dermatology, Procedural Dermatology",
            "state": "WA",
            "license": "MD00044310",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mill Creek, WA

Sources for this page

Verify at the official NPI Registry.