DR. TIMOTHY JOHN DIETRICH D.O NPI 1053654608

Internal Medicine in Maumelle, AR

NPI 1053654608 Individual Male Years of Experience 9 Internal Medicine PECOS Enrolled Accepts Medicare Approved Payment

About TIMOTHY DIETRICH

Timothy Dietrich is an internal medicine provider established in Maumelle, Arkansas and his medical specialization is internal medicine with more than 9 years of experience. The NPI number of Timothy Dietrich is 1053654608 and was assigned on April 2013. The practitioner's primary taxonomy code is 207R00000X with license number E-3259 (AR). The provider is registered as an individual and his NPI record was last updated 5 years ago.

An internist like Dr. Timothy John Dietrich D.o is a physician who has completed an internal medicine residency and is board-certified or board-eligible in an internist specialty. Internists are trained to care for adults of all ages for many different medical conditions. An internist typically monitors chronic physical conditions, identifies acute diseases, provides family planning, provides counseling about wellness and disease prevention, etc.

Timothy Dietrich is enrolled in PECOS and is eligible to order or refer healthcare services for Medicare patients. The provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices

Timothy Dietrich is registered with Medicare and accepts claims assignment, this means the provider accepts Medicare's approved amount for the cost of rendered services as full payment. Participating providers may not charge Medicare beneficiaries more than Medicare's approved amount for their services. Medicare beneficiaries still have to pay a coinsurance or copayment amount for a visit or service. According to Medicare claims data he has hospital affiliations with Baptist Health Medical Center-little Rock and White County Medical Center.

NPI

1053654608

Provider NameDR. TIMOTHY JOHN DIETRICH D.O
Provider Location Address1705 CLUB MANOR DRIVE, SUITE 2 MAUMELLE, AR 72113
Provider Mailing Address1701 CLUB MANOR DRIVE , SUITE 2 MAUMELLE, AR 72113
GenderMale
NPI Entity TypeIndividual
Medical School NameOTHER
Graduation Year2013
Is Sole Proprietor?No
Is Organization Subpart?N/A
Enumeration Date04-02-2013
Last Update Date09-02-2016


Primary Taxonomy

Taxonomy Code207R00000X
ClassificationInternal Medicine
TypeAllopathic & Osteopathic Physicians
License No.E-3259
License StateAR
Taxonomy DescriptionA 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.

Business Address

DR. TIMOTHY JOHN DIETRICH D.O
1705 CLUB MANOR DRIVE,
SUITE 2
MAUMELLE, AR
ZIP 72113
Phone: (501) 851-7402
Fax: (501) 851-4753

Get Directions


Mailing Address

DR. TIMOTHY JOHN DIETRICH D.O
1701 CLUB MANOR DRIVE
, SUITE 2
MAUMELLE, AR
ZIP 72113
Phone: (501) 851-7402
Fax: (501) 851-4753



Medicare Participation

Registered in PECOS? Yes What is PECOS?
PECOS is the Medicare Provider, Enrollment, Chain and Ownership System. PECOS is Medicare's enrollment and revalidation system and it is the primary source of information about verified Medicare professionals. A NPI number is necessary to register in PECOS. Providers must enroll in PECOS to avoid denied claims.
PECOS PAC ID446576979
PECOS Enrollment IDI20161020002351
Accepts Medicare Assignment? Yes "What does it mean "accepts medicare assignment"?
When a provider accepts Medicare assignment, the provider agrees to be paid directly by Medicare and to accept the payment amount approved by Medicare. Additionally, the provider agrees to not bill patients for more than the Medicare deductible and coinsurance amounts.
A provider who doesn't accept assignment may charge you up to 15% over the Medicare-approved amount. This is known as the limiting charge. You may have to pay this amount, or it may be covered by another insurer.
Eligible order / refer Part B Clinical Laboratory and ImagingYes
Eligible order / refer Durable Medical EquipmentYes
Eligible order / refer Home Health Agency (HHA)Yes
Eligible order / refer Power Mobility DevicesYes

Hospital Affiliations

Medicare hospital affiliation is identified through self-reporting data, inpatient, outpatient, physician and ancillary service claims linked by the Medicare claims NPI number and place of service code. Additionally, to further determine provider hospital affiliation the clinician must have provided services to at least three patients on three different dates in the last 12 months. Timothy Dietrich is affiliated with the following medical facilities:

Hospital Name Address Phone Hospital Type CMS Certification Number (CCN) Overall Rating
BAPTIST HEALTH MEDICAL CENTER-LITTLE ROCK9601 INTERSTATE
LITTLE ROCK, AR 72205
(501) 202-2000Acute Care Hospitals40114
WHITE COUNTY MEDICAL CENTER3214 EAST RACE AVENUE
SEARCY, AR 72143
(501) 278-3100Acute Care Hospitals40014

Secondary Taxonomies


The secondary taxonomy codes define the provider type, classification, and specialization. For individual NPIs the license data is associated to each taxonomy code.

No. Taxonomy Code Type Classification Specialization License No. State Primary
1390200000XStudent, Health CareStudent in an Organized Health Care Education/Training ProgramNo

Taxonomy Description: an individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

NPI Footnotes

What is the National Provider Indentifier (NPI)?
The NPI is 10-position all-numeric identification number assigned by the NPPES to uniquely identify a health care provider.

Provider Location Address
The location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.

Provider Mailing Address
The mailing address of the provider being identified. This address may contain the same information as the provider location address.

Entity Type Code
The code describing the type of health care provider that is being assigned an NPI.
The entity type codes are:
1 = Person: individual human being who furnishes health care;
2 = Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)

What is a Subpart?
Subparts are the components and separate physical locations of organization health care providers. Subpart examples include:
Hospital components include outpatient departments, surgical centers, psychiatric units, and laboratories. These components are often separately licensed or certified by States and may exist at physical locations other than that of the hospital of which they are a component.

Provider Other Organization Name
The other organization name is the alternative last name by which the provider is or has been known (if an individual) or other name by which the organization provider is or has been known. The code identifying the type of other name. The provider other organization name codes are:
1 = former name;
2 = professional name;
3 = doing business as (d/b/ a) name;
4 = former legal business name; :
5 = other.

Provider Enumeration Date
The date the provider was assigned a unique identifier (assigned an NPI).

Last Update Date
The date that a NPI record was last updated or changed.

Primary Taxonomy Code
The primary taxonomy code defines the provider type, classification, and specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Authorized Official Name
The name of the person authorized to submit the NPI application or to officially change data for a health care provider.