DR. RYAN M. DIEPENBROCK (D.D.S.) – Oral & Maxillofacial Surgery (D.M.D.), NPI 1942399159
Oral & Maxillofacial Surgery (D.M.D.)
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
42 ORAL SURGERY in IN
Provider Addresses for DR. RYAN M. DIEPENBROCK (D.D.S.)
1121 W Michigan St
Indianapolis, IN 462025211
Phone: (317) 274-7433
Fax: (317) 274-2603
Type: Location
550 University Blvd Ste 3195
Indianapolis, IN 462025149
Phone: (317) 274-7433
Fax: (317) 274-2603
Type: Location
7845 CARNEGIE BLVD STE A
FORT WAYNE, IN 468045792
Phone: (260) 423-2340
Type: Location
101, Bodin Circle, Fairfield, Solano County, California, 94535, United States
FAIRFIELD, CA 945351809
Phone: (707) 423-7085
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 7 Open Payments records for all available years, with a total value of $509.
Total Amount is formed as General ($509) + Research ($0) + Ownership ($0) = $509.
Last reported payment date: 2024-10-02 • Largest payer in this snapshot: DePuy Synthes Sales Inc. ($343).
Total Amount
$509
General + Research + Ownership
Payments
7
Total payment records
General Amount
$509
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-10-02
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| DePuy Synthes Sales Inc. | $343 |
| ZIMVIE INC. | $153 |
| Galderma Laboratories, L.P. | $13 |
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: 2019-05-01
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 |
|---|---|---|---|---|
| I20190501001946 | I | Oral Surgery | IN | 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 |
|---|---|---|---|---|
| 99202 | New patient office or other outpatient visit, 15-29 minutes | 11 | 11 | $0 |
Insurance plans in this area (ZIP 46202)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Maxillofacial Surgery, Oral Surgery, Surgical Oncology | IN | |
| - | IN | |
| Oral Surgery, Maxillofacial Surgery | IN | |
| Maxillofacial Surgery, Oral Surgery, Surgical Oncology | IN | |
| Oral Surgery | IN | |
| - | IN | |
| - | IN | |
| Nurse Practitioner | IN |
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