Travis Wade Dierks, M.D.

Primary specialty

Emergency Medical Services (Emergency Medicine) PhysicianTaxonomy code 207PE0004X

License

MD60009256 Issued in WA

Practice address

800 W 5TH Ave
Spokane, WA 99204-2803

Phone

(509) 458-5800

Fax

(509) 473-4916

NPI assigned

Apr 18, 2007

Last updated

Aug 5, 2010By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 6

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

Specialty

Emergency Medicine

Education

University of Nebraska College of Medicine, 2005

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Spokane Emergency Physicians PSGroup PAC ID 8527050731, 43 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Prov Sacred HRT Med Ctr & Childs Hosp. Hospital, Spokane, WA, CCN 500054

Merit-based Incentive Payment System (MIPS)

Final score

100 of 100Reported as group

Quality

96.06

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: tdierks353860@wm.providencedirect.org

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.

• Spokane Emergency Physicians, PS

  • Emergency Medicine Physician
  • Spokane, WA
  • NPI 1235147117
  Medicare reassignment Care Compare group
• Washington Emergency Physician Partners PLLC

  • Emergency Medicine Physician
  • Kennewick, WA
  • NPI 1346586351
  Medicare reassignment NPD
• Empire Health Services

  dba Deaconess Medical Center

  • General Acute Care Hospital
  • Spokane, WA
  • NPI 1336194893
  NPD (past)
• Spokane Emergency Medicine Associates, PS

  • Emergency Medicine Physician
  • Spokane, WA
  • NPI 1568628584
  NPD (past)
• Spokane Washington Hospital Company LLC

  dba Deaconess Medical Center

  • Registered Dietitian
  • Spokane, WA
  • NPI 1053551127
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Providence Health & Services - Wa

  dba Prov Scred Hrt Med Ctr & Chlds Hos

  • General Acute Care Hospital
  • Spokane, WA
  • NPI 1144471715
  Care Compare affiliation

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

{
    "created_epoch": "1176854400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1280966400000",
    "number": "1982820965",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 34640",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981241640",
            "telephone_number": "509-458-5800",
            "fax_number": "508-473-4916"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 W 5TH AVE",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992042803",
            "telephone_number": "509-458-5800",
            "fax_number": "509-473-4916"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIERKS",
        "first_name": "TRAVIS",
        "middle_name": "WADE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-18",
        "last_updated": "2010-08-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207PE0004X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine, Emergency Medical Services",
            "state": "WA",
            "license": "MD60009256",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1982820965",
            "state": "MT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "808064500",
            "state": "ID"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1982820965",
            "state": "ID"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "500622449",
            "state": "OR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1982820965",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8515561",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Yacine Nakia Dieng
• Angela Ruth Dierdorff, LMHCA
• David Dierdorff, DC
• Karina Dierks, M.D.
• Savannah Dierks
• Marisa Kalie Dieter, ARNP
• Michael A Dieter, PA-C
• Robert D. Dieter, PA-C
• Emily S Dietz, ARNP
• Ryan Dietz

• Emergency Medical Services (Emergency Medicine) Physician in Spokane, WA
• Providers in Spokane, WA by specialty
• Emergency Medical Services (Emergency Medicine) Physician in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 2010; 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.