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BRETT ANDREW DIETZMAN FNP
NPI 1255561825
Nurse Practitioner - Family in Johnson City, NY

Active since July 17, 2009PECOS Enrolled
33-57 HARRISON ST, JOHNSON CITY, NY 13790(607) 763-6412(607) 763-5854 Get Directions Write a Review

NPPES record last updated: November 23, 2011. Verified against the NPPES registry weekly; last sync: October 18, 2026.

About Brett Andrew Dietzman Fnp NPPES

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

BRETT ANDREW DIETZMAN FNP (NPI 1255561825) is an individual family provider in Johnson City, New York, licensed in New York (335990) and active in the NPI registry since July 2009. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1255561825
Entity TypeIndividualMale
Primary Taxonomy363LF0000X
Provider Legal NameBRETT ANDREW DIETZMANCredential: FNP
Location Address33-57 HARRISON STJohnson City, NY 13790-2107
Mailing Address346 Grand AveJohnson City, NY 13790-2580 · (607) 729-8156 · Fax (607) 729-2209
Phone(607) 763-6412
Fax(607) 763-5854
Sole ProprietorNo
Enumeration DateJuly 17, 2009
Last NPPES UpdateNovember 23, 2011
✔ NPI 1255561825 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LF0000X
License✔ Licensed in NY · 335990
33-57 HARRISON ST, Johnson City, NY 13790
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Brett Andrew Dietzman Fnp is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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 Reassignments

2

Medicare enrollment records show Brett Dietzman reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Our Lady Of Lourdes Memorial Hospital, Inc.
1.9 mi
Family Medicine
169 RIVERSIDE DR
Binghamton, NY 13905
  • Reassigned Medicare billing, New York enrollment
  • 386 clinicians in this Medicare group
NPI 1063557189 (607) 584-5459
United Medical Associates PC
2.1 mi
Clinic/Center
33 LEWIS ROAD, 2ND FLOOR
Binghamton, NY 13905
  • Reassigned Medicare billing, New York enrollment
  • 528 clinicians in this Medicare group
NPI 1013972801 (607) 770-0025

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 13790 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
$84.93 typical visit price
range $54.87 – $166.88
Typical copayment $21.23 (range $13.71 – $41.72)
Most-billed visit code 99203
Established Patient
$97.08 typical visit price
range $17.54 – $136.14
Typical copayment $24.27 (range $4.38 – $34.03)
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.

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.

TASNIMA RIA ELAHI MD
Hospitalist
33-57 HARRISON ST
JOHNSON CITY, NY 13790
Broome County (607) 763-6622
ZACHARY RONALD SECOR OTR/L
Occupational Therapist
33-57 HARRISON ST
JOHNSON CITY, NY 13790
Broome County (607) 763-6000
CAMRYN PERRI
Physician Assistant
33-57 HARRISON ST
JOHNSON CITY, NY 13790
Broome County (607) 763-6412
MOHEUDIN KHAN
Hospitalist
33-57 HARRISON ST
JOHNSON CITY, NY 13790
Broome County (607) 763-9662
DR. VINCENT MONTONE MD
Radiology (Diagnostic Radiology)
33-57 HARRISON ST
JOHNSON CITY, NY 13790
Broome County (607) 763-6104
DR. GANG YUE M.D.
Pathology (Anatomic Pathology & Clinical Pathology)
33-57 HARRISON ST
JOHNSON CITY, NY 13790
Broome County (607) 763-6151
JOHN PETER ZEVAN DO
Emergency Medicine
33-57 HARRISON ST
JOHNSON CITY, NY 13790
Broome County (607) 763-6611
ANTHONY B HOPKINS PHARMD
Pharmacist
33-57 HARRISON ST
JOHNSON CITY, NY 13790
Broome County (607) 777-5803

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 Brett Dietzman's NPI number?

The NPI number for Brett Dietzman is 1255561825. It was assigned to this individual provider in the NPPES registry on July 17, 2009.

Where is Brett Dietzman located?

Brett Dietzman practices at 33-57 Harrison St, Johnson City, NY 13790. The listed phone number is (607) 763-6412.

What is Brett Dietzman's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

Is Brett Dietzman enrolled in Medicare?

Yes. Brett Dietzman is registered in the Medicare PECOS enrollment system.

Which organizations bill Medicare for Brett Dietzman's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Brett Dietzman reassigns Medicare benefits to 2 organizations: Our Lady Of Lourdes Memorial Hospital, Inc. (Binghamton, NY) and United Medical Associates PC (Binghamton, NY). Each 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 Brett Dietzman'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 Brett Dietzman was last updated on November 23, 2011. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 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.