Jordan Dietrich, MD is a medicare enrolled "Student In An Organized Health Care Education/training Program" physician in Lebanon, New Hampshire. His current practice location is
1 Medical Dr Dept Of, Lebanon, New Hampshire. You can reach out to his office (for appointments etc.) via phone at
(603) 650-5000.
Jordan Dietrich is licensed to practice in * (Not Available) (license number ) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1255081345.
Physician's Profile
Full Name | Jordan Dietrich |
---|
Gender | Male |
---|
Speciality | Student In An Organized Health Care Education/training Program |
---|
Location | 1 Medical Dr Dept Of, Lebanon, New Hampshire |
---|
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
NPI Data:
- NPI Number: 1255081345
- Provider Enumeration Date: 03/24/2022
- Last Update Date: 11/06/2024
Medicare PECOS Information:
- PECOS PAC ID: 6507247673
- Enrollment ID: I20241126004104
Medical Identifiers
Medical identifiers for Jordan Dietrich such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1255081345 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
2084P0800X | Psychiatry & Neurology - Psychiatry | 33439 (New Hampshire) | Secondary |
390200000X | Student In An Organized Health Care Education/training Program | (* (Not Available)) | Primary |
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. Jordan Dietrich allows following entities to bill medicare on his behalf.
Entity Name | State Of New Hampshire |
---|
Entity Type | Part B Supplier - Clinic/group Practice |
---|
Entity Identifiers | NPI Number: 1861491334 PECOS PAC ID: 3870530579 Enrollment ID: O20050414000166 |
---|
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. Jordan Dietrich 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 |
Jordan Dietrich, MD 1 Medical Dr Dept Of, Lebanon, NH 03756-1000 Ph: () - | Jordan Dietrich, MD 1 Medical Dr Dept Of, Lebanon, NH 03756-1000 Ph: (603) 650-5000 |
Reviews and Comments