Terry J Dietrich, MD is a medicare enrolled "Orthopaedic Surgery" physician in New London, Wisconsin. His current practice location is
1405 Mill St, New London, Wisconsin. You can reach out to his office (for appointments etc.) via phone at
(920) 831-5050.
Terry J Dietrich is licensed to practice in Wisconsin (license number 49333-020) 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 1245274141.
Physician's Profile
Full Name | Terry J Dietrich |
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Gender | Male |
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Speciality | Orthopaedic Surgery |
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Location | 1405 Mill St, New London, Wisconsin |
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Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
NPI Data:
- NPI Number: 1245274141
- Provider Enumeration Date: 06/15/2006
- Last Update Date: 11/23/2011
Medicare PECOS Information:
- PECOS PAC ID: 8527061746
- Enrollment ID: I20060808000534
Medical Identifiers
Medical identifiers for Terry J Dietrich such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1245274141 | NPI | - | NPPES |
450030720 | Other | WI | MEDICARE PTAN |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
207X00000X | Orthopaedic Surgery | 49333-020 (Wisconsin) | 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. Terry J Dietrich allows following entities to bill medicare on his behalf.
Entity Name | Divine Savior Healthcare Inc |
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Entity Type | Part B Supplier - Clinic/group Practice |
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Entity Identifiers | NPI Number: 1124083894 PECOS PAC ID: 5799684007 Enrollment ID: O20040225000909 |
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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. Terry J 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 |
Terry J Dietrich, MD Po Box 8003, Appleton, WI 54912-8003 Ph: (920) 996-3298 | Terry J Dietrich, MD 1405 Mill St, New London, WI 54961-2155 Ph: (920) 831-5050 |
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