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DR. TIMOTHY JOHN DIETRICH D.O
NPI 1053654608
Internal Medicine in Maumelle, AR

Active since April 02, 2013PECOS EnrolledAccepts Medicare Assignment
1705 CLUB MANOR DRIVE,, SUITE 2, MAUMELLE, AR 72113(501) 851-7402(501) 851-4753 Get Directions Write a Review

NPPES record last updated: September 2, 2016. Verified against the NPPES registry weekly; last sync: August 23, 2026.

About Dr. Timothy John Dietrich D.o NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. TIMOTHY JOHN DIETRICH D.O (NPI 1053654608) is an individual internal medicine provider in Maumelle, Arkansas, licensed in Arkansas (E-3259) and active in the NPI registry since April 2013. He is enrolled in Medicare PECOS and is a graduate of Other (2013).

NPPES Registry Identity

NPI1053654608
Entity TypeIndividualMale
Primary Taxonomy207R00000X
Provider Legal NameDR. TIMOTHY JOHN DIETRICHCredential: D.O
Location Address1705 CLUB MANOR DRIVE,, SUITE 2Maumelle, AR 72113-7401
Mailing Address1701 Club Manor Drive, , Suite 2Maumelle, AR 72113-7401 · (501) 851-7402 · Fax (501) 851-4753
Phone(501) 851-7402
Fax(501) 851-4753
Sole ProprietorNo
Medical School CMSOtherGraduated 2013
Enumeration DateApril 2, 2013
Last NPPES UpdateSeptember 2, 2016
✔ NPI 1053654608 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207R00000X
License✔ Licensed in AR · E-3259
Definition
A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.
Also ListedStudent in an Organized Health Care Education/Training ProgramTaxonomy 390200000X
1705 CLUB MANOR DRIVE,, Maumelle, AR 72113
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Arkansas Health & Wellness, Ambetter from Home State Health, Ambetter from Louisiana Healthcare Connections and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Dr. Timothy John Dietrich D.o is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID446576979
PECOS Enrollment IDI20161020002351
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Areas of Expertise CMS Part B claims 4

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes 99232
Follow-up hospital inpatient care involves daily check-ups while you're admitted in the hospital. Typically, a healthcare provider spends about 25 minutes each day reviewing your condition, adjusting treatment if needed, and answering any questions you might have.
948 services296 patients
Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes 99223
Initial hospital inpatient care per day, typically 70 minutes, refers to the daily medical service provided to patients admitted to the hospital. This includes a comprehensive evaluation, diagnosis, treatment plan, and monitoring of your health condition. It ensures your well-being during your hospital stay.
242 services226 patients
Hospital discharge day management, 30 minutes or less 99238
Hospital discharge day management of 30 minutes or less includes finalizing your treatment, discussing your progress, and planning after-care at home. It ensures you're ready to leave the hospital and continue recovery safely.
183 services177 patients
Critical care, first 30-74 minutes 99291
Critical care involves immediate and constant attention by a team of specially-trained health professionals. It's for patients with life-threatening conditions, requiring first 30-74 minutes of intense monitoring and treatment.
21 services21 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 72113 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$119.36 typical visit price
range $51.36 – $157.74
Typical copayment $29.84 (range $12.84 – $39.43)
Most-billed visit code 99204
Established Patient
$91.63 typical visit price
range $16.16 – $128.77
Typical copayment $22.90 (range $4.04 – $32.19)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Referred Medical Equipment & Supplies CMS DME claims 3

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing E0431
DME-Oxygen and Supplies · category DC000N
4 suppliers49 claims49 services$16.46 avg. paid by Medicare
Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate E1390
DME-Oxygen and Supplies · category DC002N
4 suppliers49 claims49 services$74.50 avg. paid by Medicare
Lightweight wheelchair K0003
DME-Wheelchairs · category DD000N
3 suppliers12 claims12 services$18.25 avg. paid by Medicare
Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

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 Timothy Dietrich's NPI number?

The NPI number for Timothy Dietrich is 1053654608. It was assigned to this individual provider in the NPPES registry on April 2, 2013.

Where is Timothy Dietrich located?

Timothy Dietrich practices at 1705 Club Manor Drive, Suite 2, Maumelle, AR 72113. The listed phone number is (501) 851-7402.

What is Timothy Dietrich's specialty?

The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.

Is Timothy Dietrich enrolled in Medicare?

Yes. Timothy Dietrich is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

What insurance does Timothy Dietrich accept?

Health plans from Ambetter from Arkansas Health & Wellness, Ambetter from Home State Health, Ambetter from Louisiana Healthcare Connections, Ambetter from Magnolia Health and Ambetter from Superior HealthPlan and 2 other insurers list Timothy Dietrich 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 Timothy Dietrich was last updated on September 2, 2016. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 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.