DR. NICOLE ALYSSA EMMA DIETZ (MD, PHD) – Neurology Physician, NPI 1265595623
Neurology Physician
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Doctor Profile
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Profile Insights
NPPES metrics only — not quality of care.
704 NEUROLOGY in VA
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Provider Addresses for DR. NICOLE ALYSSA EMMA DIETZ (MD, PHD)
3020, Hamaker Court, Merrifield, Fairfax County, Virginia, 22031, United States
SUITE 400
FAIRFAX, VA 220312238
Phone: (703) 876-0800
Fax: (703) 876-0866
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)
CMS reports 4 Open Payments records for all available years, with a total value of $61.
Total Amount is formed as General ($61) + Research ($0) + Ownership ($0) = $61.
Last reported payment date: 2024-11-12 • Largest payer in this snapshot: ABBVIE INC. ($17).
Total Amount
$61
General + Research + Ownership
Payments
4
Total payment records
General Amount
$61
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-11-12
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| ABBVIE INC. | $17 |
| Lilly USA, LLC | $16 |
| REVANCE THERAPEUTICS, INC. | $15 |
| Amneal Pharmaceuticals LLC | $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: 2013-08-27
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 |
|---|---|---|---|---|
| I20130827000354 | I | Neurology | DC | 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 |
|---|---|---|---|---|
| J0585 | Injection, onabotulinumtoxina, 1 unit | 16,500 | 22 | $0 |
| J0588 | Injection, incobotulinumtoxin a, 1 unit | 9,700 | 28 | $0 |
| 99215 | Established patient office or other outpatient visit, 40-54 minutes | 535 | 235 | $0 |
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 281 | 192 | $0 |
| 95874 | Needle measurement of electrical activity in muscle with injection of chemical for paralysis of nerve muscle | 105 | 38 | $0 |
Insurance plans in this area (ZIP 22031)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| N E U R O L O G Y | VA | |
| N E U R O L O G Y | VA | |
| N E U R O L O G Y | VA | |
| N E U R O L O G Y | VA | |
| N E U R O L O G Y | VA | |
| N E U R O L O G Y | VA | |
| N E U R O L O G Y | NC | |
| N E U R O L O G Y | VA | |
| N E U R O L O G Y | VA | |
| N E U R O L O G Y | VA |
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