DR. MARY O'KIEF DITTRICH (MD) – Nephrology Physician, NPI 1437194552
Nephrology Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
35 NEPHROLOGY in ID
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Provider Addresses for DR. MARY O'KIEF DITTRICH (MD)
2702, South Holden Lane, Southeast Boise, Boise, Ada County, Idaho, 83706, United States
BOISE, ID 837065060
Phone:
Type: Mailing
East Louise Drive, Meridian, Ada County, Idaho, 83713, United States
STE 100
MERIDIAN, ID 836426302
Phone: (208) 846-8335
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
No Open Payments data available for this provider.
This can happen when there are no reportable CMS Open Payments records.
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2005-11-29
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.
Enrollment records
1
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20051129000038 | I | Nephrology | ID | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
Top Medicare procedures (2023) · refreshed 2026-05-27
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| 90961 | Dialysis services, 2-3 physician visits per month (20 years or older) | 163 | 21 | $0 |
| 90962 | Dialysis services, 1 physician visit per month (20 years or older) | 15 | 11 | $0 |
Insurance plans in this area (ZIP 83706)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Family Practice | ME | |
| Internal Medicine | ID | |
| Family Practice | ID | |
| - | TX | |
| - | OR | |
| Hand Surgery | ID | |
| - | ID | |
| Nurse Practitioner | ID | |
| Physician Assistant | ID | |
| General Surgery | ID |
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