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MR. JOHN BRETT DIETZE MD NPI 1588665319


NPI Information

NPI: 1588665319
Provider Name: MR. JOHN BRETT DIETZE, MD
Classification: Neurological Surgery - 207T00000X
Entity Type: Individual

PECOS Registration: Yes

Address:
2602 SAINT MICHAEL DR STE 302B
TEXARKANA, TX
ZIP 75503
Phone: (903) 794-4196
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MR. John Brett Dietze, MD is a neurological surgery in Texarkana, TX with 30 years of experience. The provider is a neurological surgeon provides the operative and non-operative management (i.e., prevention, diagnosis, evaluation, treatment, critical care, and rehabilitation) of disorders of the central, peripheral, and autonomic nervous systems, including their supporting structures and vascular supply; the evaluation and treatment of pathological processes which modify function or activity of the nervous system; and the operative and non-operative management of pain. A neurological surgeon treats patients with disorders of the nervous system; disorders of the brain, meninges, skull, and their blood supply, including the extracranial carotid and vertebral arteries; disorders of the pituitary gland; disorders of the spinal cord, meninges, and vertebral column, including those which may require treatment by spinal fusion or instrumentation; and disorders of the cranial and spinal nerves throughout their distribution. MR. John Brett Dietze, MD NPI is 1588665319. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

Education
Medical School: UNIVERSITY OF TEXAS SOUTHWESTERN MEDICAL SCHOOL AT DALLAS
Graduation Year:1994

The provider's business location address is:

2602 SAINT MICHAEL DR STE 302B
TEXARKANA, TX
ZIP 75503-228
Phone: (903) 794-4196
Fax: (903) 614-5169

The NPI 1588665319 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The following top HCPCS codes were publicly reported for this provider under the Medicare program for the year 2016. The reported codes are based on the top codes for each available Medicare specialty, excluding evaluation and management codes.

  • Insertion of device into intervertebral disc space of spine and fusion of vertebrae (HCPCS:22853)
  • Partial removal of middle spine bone with release of spinal cord and/or nerves (HCPCS:63047)
  • Partial removal of spine bone with release of spinal cord and/or nerves (HCPCS:63048)

The enumeration date for this NPI number is 8/2/2005 and was last updated on 4/28/2021.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1207T00000XNeurological SurgeryK2152TEXASYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1141100101MEDICAIDTEXAS
21871793307OTHERTEXASCIGNA DME
38A0896OTHERTEXASBLUE CROSS
498601OTHERFIRST PYRAMID LIFE
51G1885OTHERTEXASMEDICARE
6200023040AMEDICAIDOKLAHOMA
798601OTHERARKANSASBLUE CROSS
8140006859OTHERTEXASRAILROAD MEDICARE
9141100101OTHERINDIGENT HEALTH CARE
10142238001MEDICAIDARKANSAS
1118796000000OTHERARKANSASQUALCHOICE OF ARKANSAS
12179117500OTHERUS DEPT OF LABOR
135575000001OTHERTEXASCIGNA GOVERNMENT SERVICES
14MDK2152OTHERTEXASWORKERS' COMPENSATION
1598601OTHERTEXASCOLLUM & CARNEY CLINIC

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.