ELOISA B DIETRICH
NPI 1134512288
Nurse Practitioner - Psychiatric/Mental Health in San Marcos, CA
About Eloisa B Dietrich NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
ELOISA B DIETRICH (NPI 1134512288) is an individual psychiatric/mental health provider in San Marcos, California, licensed in California (363LFOOOOX) and active in the NPI registry since March 2015. She is enrolled in Medicare PECOS, maintains a secondary practice location in Lake Elsinore, and is a graduate of Other (2012).
NPPES Registry Identity
Specialties & Licenses 2
Secondary Practice Location 1
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare and accepts Medicare assignment
Eloisa B Dietrich 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.
Medicare Billing Reassignment
Medicare enrollment records show Eloisa Dietrich reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.
Fresno, CA 93710
- Reassigned Medicare billing, California enrollment
- Medicare enrollment name: Mark David Levine MD Professional Corporation
- 329 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 92069 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 20
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
SAN MARCOS, CA 92069
SAN MARCOS, CA 92069
SAN MARCOS, CA 92069
SAN MARCOS, CA 92069
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 Eloisa Dietrich's NPI number?
The NPI number for Eloisa Dietrich is 1134512288. It was assigned to this individual provider in the NPPES registry on March 13, 2015.
Where is Eloisa Dietrich located?
Eloisa Dietrich practices at 277 Rancheros Dr Ste 301, San Marcos, CA 92069. The listed phone number is (760) 471-4073.
What is Eloisa Dietrich's specialty?
The primary specialty registered for this NPI is Nurse Practitioner, specializing in Psychiatric/Mental Health, with taxonomy code 363LP0808X.
Is Eloisa Dietrich enrolled in Medicare?
Yes. Eloisa 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.
Which organization bills Medicare for Eloisa Dietrich's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Eloisa Dietrich reassigns Medicare benefits to Mark David Levine, MD Fresno (Fresno, CA). 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 Eloisa Dietrich's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
When was this NPI record last updated?
The NPPES record for Eloisa Dietrich was last updated on May 24, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.
# Eloisa B Dietrich · NPI 1134512288
Psychiatric/Mental Health physician in San Marcos, California. Individual provider, active in the CMS NPPES registry since March 13, 2015.
## Identity
- **NPI:** 1134512288 (Entity type: Individual)
- **Enumerated:** March 13, 2015
- **Primary specialty:** Nurse Practitioner - Psychiatric/Mental Health · taxonomy 363LP0808X
- **State license:** 363LFOOOOX (California)
- **Sole proprietor:** No
## Practice location
- **Address:** 277 RANCHEROS DR STE 301, San Marcos, CA 92069-2993
- **Phone:** (760) 471-4073 · **Fax:** (760) 471-4078
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Bills Medicare through:** Mark David Levine, MD Fresno (NPI 1124387097, Fresno, CA), under Medicare reassignment (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Other, class of 2012
## Record status
- **NPPES last updated:** May 24, 2024
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Source: [NPI Profile](https://npiprofile.com/npi/1134512288) · Data from the CMS NPPES public registry.