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Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 60 days.

JORDAN DIETRICH MD
NPI 1255081345
Psychiatry & Neurology - Psychiatry in Portland, OR

Active since March 24, 2022PECOS EnrolledAccepts Medicare Assignment
3550 N INTERSTATE AVE, PORTLAND, OR 97227(800) 813-2000 Get Directions Write a Review

NPPES record last updated: September 24, 2026. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Sep 24, 2026, May 6, 2026, Nov 6, 2024 (3 updates tracked since 2024).

About Jordan Dietrich Md NPPES

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

JORDAN DIETRICH MD (NPI 1255081345) is an individual psychiatry provider in Portland, Oregon, licensed in Oregon (MD229584) and active in the NPI registry since March 2022. He is enrolled in Medicare PECOS, maintains a secondary practice location in Lebanon, and is a graduate of Other (2022).

NPPES Registry Identity

NPI1255081345
Entity TypeIndividualMale
Primary Taxonomy2084P0800X
Provider Legal NameJORDAN DIETRICHCredential: MD
Location Address3550 N INTERSTATE AVEPortland, OR 97227-1196
Mailing Address500 Ne Multnomah St Ste 100Portland, OR 97232-2031
Phone(800) 813-2000
Sole ProprietorNo
Medical School CMSOtherGraduated 2022
Enumeration DateMarch 24, 2022
Last NPPES UpdateSeptember 24, 20263 updates tracked since enumeration
NPPES CertifiedSeptember 24, 2026
✔ NPI 1255081345 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPsychiatry & Neurology · PsychiatryAllopathic & Osteopathic Physicians
Taxonomy Code2084P0800X
Licenses✔ Licensed in OR · MD229584✔ Licensed in NH · 33439✔ Licensed in WA · MD.MD.70101767
Definition
A Psychiatrist specializes in the prevention, diagnosis, and treatment of mental disorders, emotional disorders, psychotic disorders, mood disorders, anxiety disorders, substance-related disorders, sexual and gender identity disorders and adjustment disorders. Biologic, psychological, and social components of illnesses are explored and understood in treatment of the whole person. Tools used may include diagnostic laboratory tests, prescribed medications, evaluation and treatment of psychological and interpersonal problems with individuals and families, and intervention for coping with stress, crises, and other problems.
Also ListedStudent in an Organized Health Care Education/Training ProgramTaxonomy 390200000X
3550 N INTERSTATE AVE, Portland, OR 97227
Open in Google Maps ↗

Secondary Practice Location 1

Location 11 Medical Dr Dept OfLebanon, NH 03756-1000 · Phone (603) 650-5000

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

Jordan Dietrich Md 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 ID6507247673
PECOS Enrollment IDI20241126004104
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.

Medicare Billing Reassignment

Medicare enrollment records show Jordan Dietrich reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

State Of New Hampshire
2,495 mi
Psychiatric Hospital
36 CLINTON ST
Concord, NH 03301
  • Reassigned Medicare billing, New Hampshire enrollment
  • 120 clinicians in this Medicare group
NPI 1861491334 (603) 271-5383

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 97227 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
$176.88 typical visit price
range $58.99 – $176.88
Typical copayment $44.22 (range $14.74 – $44.22)
Most-billed visit code 99205
Established Patient
$73.28 typical visit price
range $19.32 – $144.79
Typical copayment $18.32 (range $4.83 – $36.19)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

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.

JAMES PAUL BRYANT LCSW, CADC 3
Counselor
3550 N INTERSTATE AVE
PORTLAND, OR 97227
Multnomah County (503) 964-0000
ALISON D. ARMOUR PSYD
Psychologist (Clinical)
3550 N INTERSTATE AVE
PORTLAND, OR 97227
Multnomah County (503) 813-2000
MS. JESSICA A DUDLEY FNP
Nurse Practitioner (Family)
3550 N INTERSTATE AVE
PORTLAND, OR 97227
Multnomah County (503) 746-1575
DANAYA LEE HALL SWHNP
Nurse Practitioner
3550 N INTERSTATE AVE
PORTLAND, OR 97227
Multnomah County (800) 813-2000
MS. JANET LEE MUCKRIDGE RD LD
Dietitian, Registered
3550 N INTERSTATE AVE, NUTRITION DEPARTMENT EAST INTERSTATE
PORTLAND, OR 97227
Multnomah County (503) 286-6871
KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST
Pharmacy (Managed Care Organization Pharmacy)
3550 N INTERSTATE AVE
PORTLAND, OR 97227
Multnomah County (866) 279-6122
COURTNEY JOHNSON LCSW
Social Worker (Clinical)
3550 N INTERSTATE AVE
PORTLAND, OR 97227
Multnomah County (800) 813-2000
CHIA NENG VANG RPH
Pharmacist (Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist)
3550 N INTERSTATE AVE
PORTLAND, OR 97227
Multnomah County (866) 279-6122

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 Jordan Dietrich's NPI number?

The NPI number for Jordan Dietrich is 1255081345. It was assigned to this individual provider in the NPPES registry on March 24, 2022.

Where is Jordan Dietrich located?

Jordan Dietrich practices at 3550 N Interstate Ave, Portland, OR 97227. The listed phone number is (800) 813-2000.

What is Jordan Dietrich's specialty?

The primary specialty registered for this NPI is Psychiatry & Neurology, specializing in Psychiatry, with taxonomy code 2084P0800X.

Is Jordan Dietrich enrolled in Medicare?

Yes. Jordan 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 Jordan Dietrich's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Jordan Dietrich reassigns Medicare benefits to State Of New Hampshire (Concord, NH). 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 Jordan 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 Jordan Dietrich was last updated on September 24, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 27 days 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.