Dr Russell D Deidiker, MD is a medicare enrolled "Pathology - Anatomic Pathology & Clinical Pathology" physician in Farmington, Missouri. He went to University Of Tennessee, Hsc, College Of Medicine and graduated in 1991 and has 34 years of diverse experience with area of expertise as Pathology. He is a member of the group practice Mid-america Pathology Consultants, Llc and his current practice location is
1212 Weber Rd, Suite 205, Farmington, Missouri. You can reach out to his office (for appointments etc.) via phone at
(573) 756-4581.
Dr Russell D Deidiker is licensed to practice in Missouri (license number 113238) and he also participates in the medicare program. He
accepts medicare assignments (which means he accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and his NPI Number is 1841265345.
Physician's Profile
| Full Name | Dr Russell D Deidiker |
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| Gender | Male |
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| Speciality | Pathology |
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| Experience | 34 Years |
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| Location | 1212 Weber Rd, Farmington, Missouri |
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| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
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Medical Education and Training:
- Dr Russell D Deidiker attended and graduated from University Of Tennessee, Hsc, College Of Medicine in 1991
NPI Data:
- NPI Number: 1841265345
- Provider Enumeration Date: 02/20/2006
- Last Update Date: 07/08/2007
Medicare PECOS Information:
- PECOS PAC ID: 0547384224
- Enrollment ID: I20100901000907
Medical Identifiers
Medical identifiers for Dr Russell D Deidiker such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1841265345 | NPI | - | NPPES |
| 208729707 | Medicaid | MO | |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 207ZP0102X | Pathology - Anatomic Pathology & Clinical Pathology | 113238 (Missouri) | Primary |
Medical Facilities Affiliation
Group Practice Association
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|
| Mid-america Pathology Consultants, Llc | 0648569210 | 2 |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Dr Russell D Deidiker allows following entities to bill medicare on his behalf.
| Entity Name | Southeast Missouri Hospital Physicians Llc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1558311522
PECOS PAC ID: 9133024334
Enrollment ID: O20031201000775 |
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| Entity Name | American Multispecialty Group Inc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1972559532
PECOS PAC ID: 1658365572
Enrollment ID: O20040413001412 |
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| Entity Name | Mid-america Pathology Consultants, Llc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1194193326
PECOS PAC ID: 0648569210
Enrollment ID: O20160520001258 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Dr Russell D Deidiker is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
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Dr Russell D Deidiker, MD
312 Louise St,
Farmington, MO 63640-2706
Ph: (573) 756-4581 | Dr Russell D Deidiker, MD
1212 Weber Rd, Suite 205,
Farmington, MO 63640-3325
Ph: (573) 756-4581 |
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