DR. JACK DIEP MD NPI 1912333014

NPI Information

  • NPI: 1912333014
  • Provider Name: DR. JACK DIEP, MD
  • Classification: Pain Medicine - 208VP0014X
  • Specialization: Interventional Pain Medicine
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 1791 MESQUITE AVE
    LAKE HAVASU CITY, AZ
    ZIP 86403
  • Phone: (928) 505-5555

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NPI Details

DR. Jack Diep, MD is an interventional pain medicine pain medicine in Lake Havasu City, AZ with 13 years of experience. The provider is interventional Pain Medicine is the discipline of medicine devoted to the diagnosis and treatment of pain and related disorders principally with the application of interventional techniques in managing subacute, chronic, persistent, and intractable pain, independently or in conjunction with other modalities of treatment. DR. Jack Diep, MD NPI is 1912333014. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

1791 MESQUITE AVE
LAKE HAVASU CITY, AZ
ZIP 86403-648
Phone: (928) 505-5555
Fax: (928) 505-2877

The NPI 1912333014 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.

  • Injection, dexamethasone sodium phosphate, 1 mg (HCPCS:J1100)
  • Injection, triamcinolone acetonide, not otherwise specified, 10 mg (HCPCS:J3301)
  • Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml (HCPCS:Q9967)
  • Established patient office or other outpatient visit, 30-39 minutes (HCPCS:99214)
  • Hyaluronan or derivitive, genvisc 850, for intra-articular injection, 1 mg (HCPCS:J7320)
  • Established patient office or other outpatient visit, 20-29 minutes (HCPCS:99213)
  • New patient office or other outpatient visit, 45-59 minutes (HCPCS:99204)
  • Testing for presence of drug, by chemistry analyzers (HCPCS:80307)
  • Injection of anesthetic and/or steroid drug into sacral spine nerve root using imaging guidance, single level (HCPCS:64483)
  • Ultrasonic guidance for needle placement (HCPCS:76942)
  • Injection of trigger points, 3 or more muscles (HCPCS:20553)
  • Injection, cefazolin sodium, 500 mg (HCPCS:J0690)
  • Injection, ketorolac tromethamine, per 15 mg (HCPCS:J1885)
  • Fluoroscopic guidance for needle placement (HCPCS:77002)
  • Aspiration and/or injection of fluid from large joint (HCPCS:20610)
  • Destruction of lower or sacral spinal facet joint nerves using imaging guidance, each additional facet joint (HCPCS:64636)
  • Destruction of lower or sacral spinal facet joint nerves using imaging guidance, single facet joint (HCPCS:64635)
  • Injection of substance into middle or upper spine canal using imaging guidance (HCPCS:62321)
  • Injection of lower or sacral spine facet joint using imaging guidance, single level (HCPCS:64493)
  • Injection of lower or sacral spine facet joint using imaging guidance, second level (HCPCS:64494)
  • Injection of substance into lower spine canal using imaging guidance (HCPCS:62323)
  • Insertion of spinal neurostimulator electrode array through skin (HCPCS:63650)
  • Electronic analysis of implanted neurostimulator generator with complex spinal cord or peripheral nerve stimulator programming (HCPCS:95972)
  • Injection of anesthetic and/or steroid drug into sacral spine nerve root using imaging guidance, each additional level (HCPCS:64484)
  • Injection of anesthetic or steroid into joint between lower spine and hip bone using imaging guidance (HCPCS:27096)
  • X-ray of lower and sacral spine, 2-3 views (HCPCS:72100)
  • Mri scan of lower spinal canal without contrast (HCPCS:72148)
  • X-ray lower and sacral spine, 2-3 views bending views (HCPCS:72120)
  • Insertion of spinal neurostimulator electrode array through skin (HCPCS:63650)
  • X-ray of middle spine, 2 views (HCPCS:72070)
  • Injection of upper or middle spine facet joint using imaging guidance, single level (HCPCS:64490)
  • Injection of upper or middle spine facet joint using imaging guidance, second level (HCPCS:64491)
  • X-ray of upper spine, 2-3 views (HCPCS:72040)
  • X-ray lower and sacral spine, minimum of 6 views (HCPCS:72114)
  • Mri scan of middle spinal canal without contrast (HCPCS:72146)
  • Insertion of spinal neurostimulator generator or receiver (HCPCS:63685)
  • Destruction of nerves supplying joint between spine and pelvis using imaging guidance (HCPCS:64625)
  • Electronic analysis of implanted neurostimulator generator with complex spinal cord or peripheral nerve stimulator programming (HCPCS:95972)
  • Mri scan of upper spinal canal without contrast (HCPCS:72141)
  • Destruction of upper or middle spinal facet joint nerves using imaging guidance, single facet joint (HCPCS:64633)
  • Destruction of upper or middle spinal facet joint nerves using imaging guidance, each additional facet joint (HCPCS:64634)
  • X-ray of hip, 2-3 views (HCPCS:73502)
  • X-ray of shoulder, minimum of 2 views (HCPCS:73030)
  • Spinal fusion (HCPCS:NAN02)

The enumeration date for this NPI number is 9/20/2013 and was last updated on 9/27/2022.

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 Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1207LP2900XAnesthesiologyPain Medicine55528ARIZONANo
2208VP0000XPain MedicinePain Medicine55528ARIZONANo
3208VP0014XPain MedicineInterventional Pain Medicine55528ARIZONAYes

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 Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1369607MEDICAIDARIZONA

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: 11/21/2025

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