LEE A DIENER – Psychiatric/Mental Health Nurse Practitioner, NPI 1790444917

LEE A DIENER is a healthcare provider. based in Marne, Michigan. specializing in NURSE PRACTITIONER. They hold a License No. 4704320707 (MI). The NPI Number for LEE A DIENER is 1790444917

Main info

Female
4 Years Of Experience
Accepts Medicare Assignment
Name
LEE A DIENER
NPI
1790444917
Phone
(844) 776-9651
Address
15146 16TH AVE
Enumeration Date
15 December 2021
Last Update Date
5 April 2023

Doctor Profile

Medical School Name
OTHER
Secondary Phone
2692564700
Graduation Year
2022 (4 years ago)
PAC ID
3274986351
Group Practice PAC ID
4688031578
Professional Enrollment ID
I20240126001576
Address ID
MI490154274BA5550XRDXX400

Contacts

Secure Messaging
ldiener@sanfordhouse.com
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience37
Completeness85
Years active:4State licenses:1Other namesUpdated within 12 months

8,106 NURSE PRACTITIONER in MI

Provider Addresses for LEE A DIENER

  • 15146 16TH AVE

    MARNE, MI 494359605

    Phone: (844) 776-9651

    Mailing address matches the actual address.

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: 2024-01-26

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

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20240126001576INurse PractitionerMITBD

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.

Verify on CMS Revalidation Lookup Tool

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.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 49435)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 4688031578View full group profile
NameSpecialtyState
P S Y C H I A T R YCO
Physician AssistantMI
P S Y C H I A T R YMI
P S Y C H I A T R YMI
Nurse PractitionerMI
P S Y C H I A T R YMI
Nurse PractitionerMI
P S Y C H I A T R YMT
Nurse PractitionerMI
P S Y C H I A T R YMI

Reviews

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Frequently asked questions

How do I look up LEE A DIENER by NPI?
Use NPI 1790444917 when you need to reference LEE A DIENER in forms, claims, or directories.
Is LEE A DIENER's enrollment marked active?
An active flag here means the NPI record is not in a deactivated state.
Can you summarize LEE A DIENER's specialty in plain language?
Clinically, the directory lists LEE A DIENER with Psychiatric/Mental Health Nurse Practitioner. Clinical services aligned with this taxonomy classification.
Where is LEE A DIENER's primary listing?
We display Marne, Michigan because that is what the record indicates for LEE A DIENER.
Does Medicare enrollment show here?
Medicare enrollment screens are separate from the basic NPI extract shown here.

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