KATHRYN M DIETZ (PA-C) – Physician Assistant, NPI 1255861902
Physician Assistant
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Profile Insights
NPPES metrics only — not quality of care.
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Provider Addresses for KATHRYN M DIETZ (PA-C)
Hospital Drive, Columbia, Boone County, Missouri, 65212, United States
COLUMBIA, MO 652120001
Phone: (573) 882-6955
Fax: (573) 884-0437
Type: Location
1 Hospital Dr # Dc011.0
Columbia, MO 652121000
Phone: (573) 882-6955
Type: Location
Jack in the Box, South 18th Street, Kansas City, Wyandotte County, Kansas, 66102, United States
KANSAS CITY, MO 641843966
Phone: (573) 882-3300
Fax: (573) 884-0943
Type: Mailing
1 HOSPITAL DR
COLUMBIA, MO 652120001
Phone: (573) 882-6955
Fax: (573) 884-0437
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 1 Open Payments records for all available years, with a total value of $14.
Total Amount is formed as General ($14) + Research ($0) + Ownership ($0) = $14.
Last reported payment date: 2024-12-05 • Largest payer in this snapshot: Chiesi USA, Inc. ($14).
Total Amount
$14
General + Research + Ownership
Payments
1
Total payment records
General Amount
$14
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-12-05
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Chiesi USA, Inc. | $14 |
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: 2017-08-03
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 |
|---|---|---|---|---|
| I20170803001629 | I | Physician Assistant | MO | 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 |
|---|---|---|---|---|
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 16 | 16 | $0 |
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 15 | 15 | $0 |
| 99204 | New patient office or other outpatient visit, 45-59 minutes | 12 | 12 | $0 |
Insurance plans in this area (ZIP 65212)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| - | MO | |
| Family Practice | MO | |
| Nurse Practitioner | MO | |
| Nurse Practitioner | MO | |
| Osteopathic Manipulative Medicine, Family Practice | WY | |
| - | MO | |
| Nurse Practitioner | MO |
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