DR. HENRY T. III DIETRICH (M.D.) – Addiction Medicine (Family Medicine) Physician, NPI 1922074046
Addiction Medicine (Family Medicine) Physician
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Doctor Profile
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Profile Insights
NPPES metrics only — not quality of care.
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Provider Addresses for DR. HENRY T. III DIETRICH (M.D.)
Geisinger Medical Center Danville, 100, North Academy Avenue, Danville, Montour County, Pennsylvania, 17822, United States
CREDENTIALS DEPT
DANVILLE, PA 178224903
Phone: (570) 271-6144
Type: Mailing
425, Market Street, Downtown, Williamsport, Lycoming County, Pennsylvania, 17701, United States
WILLIAMSPORT, PA 177016345
Phone: (570) 368-4477
Fax: (570) 368-4476
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 $26.
Total Amount is formed as General ($26) + Research ($0) + Ownership ($0) = $26.
Last reported payment date: 2023-02-07 • Largest payer in this snapshot: Alkermes, Inc. ($26).
Total Amount
$26
General + Research + Ownership
Payments
1
Total payment records
General Amount
$26
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2023-02-07
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Alkermes, Inc. | $26 |
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: 2005-05-16
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 |
|---|---|---|---|---|
| I20050516000082 | I | Internal Medicine | PA | 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 |
|---|---|---|---|---|
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 122 | 26 | $0 |
Insurance plans in this area (ZIP 17822)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| - | NC | |
| - | PA | |
| P S Y C H I A T R Y | NY | |
| Internal Medicine, Hospice/Palliative Care | PA | |
| - | PA | |
| Nurse Practitioner | PA | |
| Physician Assistant | PA | |
| - | PA | |
| - | PA | |
| Physician Assistant | PA |
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