Mr John Brett Dietze, MD in Texarkana, TX

Mr John Brett Dietze, MD is a medicare enrolled "Neurological Surgery" physician in Texarkana, Texas. He went to University Of Texas Southwestern Medical School At Dallas and graduated in 1994 and has 31 years of diverse experience with area of expertise as Neurosurgery. He is a member of the group practice Providence Health Alliance and his current practice location is 2602 Saint Michael Dr Ste 302b, Texarkana, Texas. You can reach out to his office (for appointments etc.) via phone at (903) 794-4196.

Mr John Brett Dietze is licensed to practice in Texas (license number K2152) 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 1588665319.

Contact Information

	Mr John Brett Dietze, MD
	2602 Saint Michael Dr Ste 302b, Texarkana, TX 75503-5228
	(903) 794-4196
	(903) 614-5169

Map and Direction

Physician's Profile

Full Name	Mr John Brett Dietze
Gender	Male
Speciality	Neurosurgery
Experience	31 Years
Location	2602 Saint Michael Dr Ste 302b, Texarkana, Texas
Accepts Medicare Assignments	Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance.

Medical Education and Training:

Mr John Brett Dietze attended and graduated from University Of Texas Southwestern Medical School At Dallas in 1994

NPI Data:

NPI Number: 1588665319
Provider Enumeration Date: 08/02/2005
Last Update Date: 04/28/2021

Medicare PECOS Information:

PECOS PAC ID: 6709789308
Enrollment ID: I20051215000733

Medical Identifiers

Medical identifiers for Mr John Brett Dietze such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1588665319	NPI	-	NPPES
1G1885	Other	TX	MEDICARE
141100101	Other		INDIGENT HEALTH CARE
18796000000	Other	AR	QUALCHOICE OF ARKANSAS
98601	Other	TX	COLLUM & CARNEY CLINIC
98601	Other	AR	BLUE CROSS
179117500	Other		US DEPT OF LABOR
1871793307	Other	TX	CIGNA DME
8A0896	Other	TX	BLUE CROSS
140006859	Other	TX	RAILROAD MEDICARE
141100101	Medicaid	TX
142238001	Medicaid	AR
200023040A	Medicaid	OK
5575000001	Other	TX	CIGNA GOVERNMENT SERVICES
MDK2152	Other	TX	WORKERS' COMPENSATION
98601	Other		FIRST PYRAMID LIFE

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
207T00000X	Neurological Surgery	K2152 (Texas)	Primary

Medical Facilities Affiliation

Facility Name	Location	Facility Type
Providence Health Center	Waco, TX	Hospital

Group Practice Association

Group Practice Name	Group PECOS PAC ID	No. of Members
Providence Health Alliance	6305731068	115

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. Mr John Brett Dietze allows following entities to bill medicare on his behalf.

Entity Name	Christus Trinity Clinic
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1285684225 PECOS PAC ID: 3072426741 Enrollment ID: O20031204001091

Entity Name	Providence Health Alliance
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1932210838 PECOS PAC ID: 6305731068 Enrollment ID: O20040220000307

Entity Name	C H Wilkinson Physician Network
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1457382947 PECOS PAC ID: 8921919580 Enrollment ID: O20041203000584

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. Mr John Brett Dietze 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
Mr John Brett Dietze, MD P O Box 9600, Dept 09-019, Texarkana, TX 75505-9600 Ph: (903) 794-4196	Mr John Brett Dietze, MD 2602 Saint Michael Dr Ste 302b, Texarkana, TX 75503-5228 Ph: (903) 794-4196

Reviews and Comments

Neurological Surgery Doctors in Texarkana, TX

Mr. Marcus Andrew Smith, M.D. Neurological Surgery Medicare: Accepting Medicare Assignments Practice Location: 2602 Saint Michael Dr Ste 302b, Texarkana, TX 75503 Phone: 903-794-4196 Fax: 903-614-5190
Mr. Freddie L Contreras, MD Neurological Surgery Medicare: Accepting Medicare Assignments Practice Location: 1002 Texas Blvd, Ste 406, Texarkana, TX 75501 Phone: 903-794-4196 Fax: 903-792-7408
Dr. Walid Ibn Essayed, M.D. Neurological Surgery Medicare: Accepting Medicare Assignments Practice Location: 2604 Saint Michael Dr, Texarkana, TX 75503 Phone: 903-614-5180

Mr John Brett Dietze, MD - Medicare Neurosurgery in Texarkana, TX