LUCAS ALAN DIETRICH PA
NPI 1689918278
Physician Assistant in Winston Salem, NC

Q: What is Lucas Dietrich's NPI number?

The NPI number for Lucas Dietrich is 1689918278. It was assigned to this individual provider in the NPPES registry on November 20, 2012.

Q: What is Lucas Dietrich's specialty?

The primary specialty registered for this NPI is Physician Assistant with taxonomy code 363A00000X.

Q: When was this NPI record last updated?

The NPPES record for Lucas Dietrich was last updated on October 24, 2023. 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.

Active since November 20, 2012PECOS Enrolled

3001 LYNDHURST AVE, WINSTON SALEM, NC 27103(336) 765-0383 Get Directions Write a Review

NPPES record last updated: October 24, 2023. Verified against the NPPES registry weekly; last sync: August 30, 2026.

Record update history: Oct 24, 2023, Feb 10, 2021, Oct 18, 2018 (3 updates tracked since 2018).

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About Lucas Alan Dietrich Pa NPPES

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

LUCAS ALAN DIETRICH PA (NPI 1689918278) is an individual physician assistant in Winston Salem, North Carolina, licensed in North Carolina (0010-08128) and active in the NPI registry since November 2012. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1689918278

Entity TypeIndividualMale

Primary Taxonomy363A00000X

Provider Legal NameLUCAS ALAN DIETRICHCredential: PA

Location Address3001 LYNDHURST AVEWinston Salem, NC 27103-4007

Mailing Address3001 Lyndhurst AveWinston Salem, NC 27103-4007 · (336) 765-0383 · Fax (336) 768-1737

Phone(336) 765-0383

Sole ProprietorNo

Enumeration DateNovember 20, 2012

Last NPPES UpdateOctober 24, 20233 updates tracked since enumeration

NPPES CertifiedOctober 24, 2023

✔ NPI 1689918278 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician AssistantPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363A00000X

Licenses✔ Licensed in NC · 0010-08128✔ Licensed in CO · 3555

Definition

A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.

3001 LYNDHURST AVE, Winston Salem, NC 27103

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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Cross and Blue Shield of NC.Insurance ›

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Lucas Alan Dietrich Pa 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.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 27103 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

$83.90 typical visit price

range $54.12 – $165.09

Typical copayment $20.97 (range $13.53 – $41.27)

Most-billed visit code 99203

Established Patient

$67.72 typical visit price

range $17.21 – $134.61

Typical copayment $16.93 (range $4.30 – $33.65)

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.

SETH RYAN ANDERSON PA-C

Physician Assistant