JASON PAUL DIETERLE (DO) – Sports Medicine (Orthopaedic Surgery) Physician, NPI 1376730069
Sports Medicine (Orthopaedic Surgery) Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
819 ORTHOPEDIC SURGERY in MN
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Provider Addresses for JASON PAUL DIETERLE (DO)
5803, Neal Avenue North, Oak Park Heights, Washington County, Minnesota, 55082, United States
OAK PARK HEIGHTS, MN 550822177
Phone: (651) 439-8807
Fax: (651) 439-0232
Type: Mailing
3500 AMERICAN BLVD W STE 300
BLOOMINGTON, MN 554314442
Phone: (952) 512-5600
Type: Mailing
5715 MEMORIAL AVE N
OAK PARK HEIGHTS, MN 550821093
Phone: (651) 439-8807
Fax: (651) 439-0232
Type: Location
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 $292.
Total Amount is formed as General ($292) + Research ($0) + Ownership ($0) = $292.
Last reported payment date: 2024-11-22 • Largest payer in this snapshot: Foundation Medical, Llc ($188).
Total Amount
$292
General + Research + Ownership
Payments
7
Total payment records
General Amount
$292
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
2
Ownership records
Last Payment Date
2024-11-22
Latest reported date
Top Companies
Largest payers in this snapshot
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: 2025-01-14
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking 2 Medicare enrollment records; no due dates published yet.
Enrollment records
2
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 |
|---|---|---|---|---|
| I20090814000501 | I | Orthopedic Surgery | WI | TBD |
| I20250114002429 | I | Orthopedic Surgery | MI | 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 |
|---|---|---|---|---|
| J3301 | Injection, triamcinolone acetonide, not otherwise specified, 10 mg | 852 | 114 | $0 |
| 20610 | Aspiration and/or injection of fluid from large joint | 196 | 115 | $0 |
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 170 | 126 | $0 |
| 73030 | X-ray of shoulder, minimum of 2 views | 109 | 75 | $0 |
| 73562 | X-ray of knee, 3 views | 52 | 41 | $0 |
Insurance plans in this area (ZIP 55082)
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Provider's Procedures
| Specialty | Practice State | HCPCS Code | Description | Service Count | Beneficiary Count |
|---|---|---|---|---|---|
| ORTHOPEDIC SURGERY | MN | 73562 | X-ray of knee, 3 views | 27 | 21 |
Group practice members
| Name | Specialty | State |
|---|---|---|
| General Surgery | MI | |
| Nurse Practitioner | MI | |
| Physician Assistant | MI | |
| U R O L O G Y | TN | |
| Nurse Practitioner | MI | |
| Nurse Practitioner | MI | |
| - | MI | |
| Internal Medicine | MI | |
| Family Practice | MI | |
| Infectious Disease, Internal Medicine | MI |
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