SAMANTHA DIETERICH M.D.
NPI 1043437940
Pediatrics in Round Rock, TX
About Samantha Dieterich M.d. NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
SAMANTHA DIETERICH M.D. (NPI 1043437940) is an individual pediatrics provider in Round Rock, Texas, licensed in Texas (M6588) and active in the NPI registry since April 2007. She is enrolled in Medicare PECOS.
NPPES Registry Identity
Specialties & Licenses
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Samantha Dieterich M.d. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Billing Reassignment
Medicare enrollment records show Samantha Dieterich reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.
Pflugerville, TX 78660
- Reassigned Medicare billing, Texas enrollment
- 2,795 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Physician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 78664 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
Other Providers at the Same Location NPPES 4
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
ROUND ROCK, TX 78664
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Samantha Dieterich's NPI number?
The NPI number for Samantha Dieterich is 1043437940. It was assigned to this individual provider in the NPPES registry on April 20, 2007.
Where is Samantha Dieterich located?
Samantha Dieterich practices at 300 University Blvd, Round Rock, TX 78664. The listed phone number is (512) 509-0203.
What is Samantha Dieterich's specialty?
The primary specialty registered for this NPI is Pediatrics with taxonomy code 208000000X.
Is Samantha Dieterich enrolled in Medicare?
Yes. Samantha Dieterich is registered in the Medicare PECOS enrollment system.
Which organization bills Medicare for Samantha Dieterich's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Samantha Dieterich reassigns Medicare benefits to Scott & White Clinic (Pflugerville, TX). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Samantha Dieterich's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
What insurance does Samantha Dieterich accept?
Health plans from Baylor Scott and White Health Plan and Blue Cross and Blue Shield of Texas list Samantha Dieterich as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.
When was this NPI record last updated?
The NPPES record for Samantha Dieterich was last updated on January 11, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Samantha Dieterich, M.D. · NPI 1043437940
Pediatrics physician in Round Rock, Texas. Individual provider, active in the CMS NPPES registry since April 20, 2007.
## Identity
- **NPI:** 1043437940 (Entity type: Individual)
- **Enumerated:** April 20, 2007
- **Primary specialty:** Pediatrics · taxonomy 208000000X
- **State license:** M6588 (Texas)
- **Sole proprietor:** Yes
## Practice location
- **Address:** 300 UNIVERSITY BLVD, Round Rock, TX 78664-1032
- **Phone:** (512) 509-0203
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Bills Medicare through:** Scott & White Clinic (NPI 1679691729, Pflugerville, TX), under Medicare reassignment (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** January 11, 2021
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Source: [NPI Profile](https://npiprofile.com/npi/1043437940) · Data from the CMS NPPES public registry.