Active NPI
Elizabeth Dietz, MD
- Pediatrics Physician
- Saint Paul, MN
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- 36997
- Practice address
- 1020 Bandana Blvd W
Saint Paul, MN 55108-5107 - Phone
- (651) 241-9700
- NPI assigned
- Jul 11, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 36997 | MN | Primary |
Addresses
Primary practice location
1020 Bandana Blvd W
Saint Paul, MN 55108-5107
Mailing address
2925 Chicago Ave
Minneapolis, MN 55407-1321
Phone (612) 262-5000
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MN
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20130708000331 | MN | Practitioner - Pediatric Medicine | 2466692827 | Reassigns benefits to 2 organizations |
Care Compare profile
Medicare Care Compare- Specialty
- Pediatric Medicine
- Education
- University of Minnesota Medical School, 1991
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Allina Health System
Practice addresses (Care Compare)
440 Elm St E
Annandale, MN 55302-1109
Phone (320) 682-5225
Merit-based Incentive Payment System (MIPS)
- Final score
- 85.6 of 100
- Quality
- 72.5
- Promoting interoperability
- 100
- Improvement activities
- 40
- Cost
- 77.07
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Allina Health System | Current | Accepting new patients | |
| Allina Health System | Current | Accepting new patients | |
| Allina Health System | Current | Accepting new patients | |
| Allina Health System | Current | Accepting new patients | |
| Allina Health System | Past | Accepting new patients |
Locations
440 Elm St E
Annandale, MN 55302
Phone (320) 682-5225
2925 Chicago Ave
#10957
Minneapolis, MN 55407
Phone (612) 262-8640
2925 Chicago Ave
Minneapolis, MN 55407
Phone (612) 262-4813
7373 France Ave S
Ste 202
Minneapolis, MN 55435
Phone (952) 835-1311
1021 Bandana Blvd E
Ste 100
Saint Paul, MN 55108
Phone (877) 414-2533
1020 Bandana Blvd W
Saint Paul, MN 55108
Phone (651) 641-1000
Interoperability endpoints
- edietz90902@excellian.direct.allina.com
Organizations & group practices 5
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.
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- NPI 1952146516
-
- Family Medicine Physician
- Minneapolis, MN
- NPI 1467758813
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1152576000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1321920000000",
"number": "1992730634",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2925 CHICAGO AVE",
"city": "MINNEAPOLIS",
"state": "MN",
"postal_code": "554071321",
"telephone_number": "612-262-5000"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1020 BANDANA BLVD W",
"city": "SAINT PAUL",
"state": "MN",
"postal_code": "551085107",
"telephone_number": "651-241-9700"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DIETZ",
"first_name": "ELIZABETH",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-07-11",
"last_updated": "2011-11-22",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "MN",
"license": "36997",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Saint Paul, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 22, 2011; 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.