FERNANDO JR. DIETSCH (M.D.) – Family Medicine Physician, NPI 1962455535
Family Medicine Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
1,206 EMERGENCY MEDICINE in WA
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Provider Addresses for FERNANDO JR. DIETSCH (M.D.)
Imperial Street, Walla Walla, Walla Walla County, Washington, 99362, United States
WALLA WALLA, WA 993624457
Phone: (509) 301-9342
Fax: (509) 786-6612
Type: Mailing
Prosser Memorial Hospital, 723, Memorial Street, Prosser, Benton County, Washington, 99350, United States
PROSSER, WA 993501524
Phone: (509) 786-2222
Fax: (509) 786-6612
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 $29.
Total Amount is formed as General ($29) + Research ($0) + Ownership ($0) = $29.
Last reported payment date: 2024-04-17 • Largest payer in this snapshot: MIMEDX Group, Inc. ($29).
Total Amount
$29
General + Research + Ownership
Payments
1
Total payment records
General Amount
$29
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-04-17
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| MIMEDX Group, Inc. | $29 |
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: 2010-03-15
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 |
|---|---|---|---|---|
| I20051219000996 | I | Family Practice | WA | TBD |
| I20100315000766 | I | Emergency Medicine | OR | 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.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 99362)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Nurse Practitioner | WA | |
| - | WA | |
| Nurse Practitioner | WA | |
| Nurse Practitioner | WA | |
| - | WA |
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