DR. THOMAS WILLIAM DIETZMAN (NPI# 1548608110) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1548608110 |
| Entity Type | Individual |
| Full Name | DR. THOMAS WILLIAM DIETZMAN |
| Credential | M.D. |
| Practice Address |
3401 Civic Center Blvd Division of Cardiology Philadelphia PA 19104-4319 |
| Mailing Address |
3401 Civic Center Blvd Division of Pediatric Cardiology Philadelphia PA 19104 |
| Practice Telephone | 2155902367 |
| Mailing Telephone | 2155901220 |
| Mailing Fax Number | 2155902768 |
| Enumeration Date | 2013-06-05 |
| Last Update Date | 2020-08-10 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207LC0200X |
Anesthesiology Specialization: Critical Care Medicine |
MD457635 | PA | Allopathic & Osteopathic Physicians |
| Y | 2080P0202X |
Pediatrics Specialization: Pediatric Cardiology |
MD457635 | PA | Allopathic & Osteopathic Physicians |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 3401 Civic Center Blvd Ste 9329, Philadelphia, PA 191044319 | 2155901858 | 2155901415 |
| Street Address |
3401 CIVIC CENTER BLVD DIVISION OF CARDIOLOGY |
| City | PHILADELPHIA |
| State | PA |
| Zip Code | 19104-4319 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467458463 | Jeffrey R Boris | Pediatrics | 3401 Civic Center Blvd, Children's Hospital of Philadelphia - Cardiology, Philadelphia, PA 19104-4319 | 2005-06-23 |
| 1932700259 | Rukhsar Karim Machiwalla | Physician Assistant | 3401 Civic Center Blvd, Philadelphia, PA 19104-4319 | 2020-11-03 |
| 1346840519 | Vanessa Leigh Jones | Nurse Practitioner | 3401 Civic Center Blvd, Philadelphia, PA 19104-4319 | 2020-10-27 |
| 1275131849 | Kelsey Ann Maher | Physician Assistant | 3401 Civic Center Blvd, Philadelphia, PA 19104-4319 | 2020-10-15 |
| 1437756020 | Jennifer-rose Eccles | Nurse Practitioner | 3401 Civic Center Blvd, Philadelphia, PA 19104-4319 | 2020-10-06 |
| 1891309787 | Morgan Mcmanus | Genetic Counselor, MS | 3401 Civic Center Blvd, Philadelphia, PA 19104-4319 | 2020-09-08 |
| 1891309456 | Abigail G Stefanides | Physician Assistant | 3401 Civic Center Blvd, Philadelphia, PA 19104-4319 | 2020-09-01 |
| 1124631247 | Abrar Khaled Alabdulhadi | Pediatrics | 3401 Civic Center Blvd, Philadelphia, PA 19104-4319 | 2020-08-28 |
| 1003427014 | Terrence Caldwell Jr. | Pharmacist | 3401 Civic Center Blvd, Philadelphia, PA 19104-4319 | 2020-08-13 |
| 1760093298 | Paige Emily Naschke | Nurse Practitioner | 3401 Civic Center Blvd, Philadelphia, PA 19104-4319 | 2020-08-10 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639770829 | Michelle Morris | Student in an Organized Health Care Education/Training Program | Dept. of Family Medicine & Community Health, 3737 Market, Philadelphia, PA 19104 | 2020-11-04 |
| 1346853041 | Spectrum Health Services, Inc. | Clinic/Center | 1415 South University Ave, Philadelphia, PA 19104 | 2020-08-24 |
| 1770104259 | Fatimah Sorefan-mangou | Student in an Organized Health Care Education/Training Program | 4 Maloney 3400 Spruce Street, Philadelphia, PA 19104 | 2020-05-06 |
| 1114548690 | Rebecca Blaguski | Registered Nurse | The Hospital of The University of Pennsylvania, 3400 Spruce Street, Philadelphia, PA 19104 | 2020-05-06 |
| 1952944175 | Rebecca Miriam Barmherzig | Psychiatry & Neurology | 3501 Civic Centre Blvd, 10th Flr Ctrb, Neurology, Philadelphia, PA 19104 | 2019-10-21 |
| 1891257101 | James Paul Byrne | Surgery | Penn Presbyterian Medical Center, Division of Trauma, S, 51 N. 39th Street, Suite 120, 1st Floor Medical Office, Philadelphia, PA 19104 | 2019-04-04 |
| 1093276453 | Lauren Shreve | Student in an Organized Health Care Education/Training Program | Department of Surgery, Surgery Education - Penn Health, 3400 Spruce Street, 4 Maloney, Philadelphia, PA 19104 | 2019-03-28 |
| 1285194282 | Lauren M Christie | Student in an Organized Health Care Education/Training Program | Penn Presbyterian Medical Center, 51 N. 39th Street, Philadelphia, PA 19104 | 2019-03-25 |
| 1114487683 | Sabrina Layne | Student in an Organized Health Care Education/Training Program | 3400 Spruce Street, 100 Centrex, Philadelphia, PA 19104 | 2019-03-21 |
| 1811457310 | Kia Lor | Student in an Organized Health Care Education/Training Program | Hospital of University of Pennsylvania, 3400 Spruce St., Philadelphia, PA 19104 | 2019-03-21 |
| Find all providers in zip 19104 | ||||
| Taxonomy Code | 2080P0202X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| Specialization | Pediatric Cardiology |
| A pediatric cardiologist provides comprehensive care to patients with cardiovascular problems. This specialist is skilled in selecting, performing and evaluating the structural and functional assessment of the heart and blood vessels, and the clinical evaluation of cardiovascular disease. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. American Osteopathic Board of Pediatrics, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. Board certification for Doctors of Osteopathy (DOs) was provided by the American Osteopathic Board of Pediatrics. The Certification is no longer offered. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316363716 | Alan Marc Mendelsohn | Pediatrics | 628 S Mount Pleasant Rd, Philadelphia, PA 19119-2957 | 2014-03-10 |
| 1598962417 | Cara Angela Garofalo | Pediatrics | Erie Ave. At Front Street, St. Christopher's Hospital for Children, Philadelphia, PA 19134 | 2007-07-03 |
| 1467458463 | Jeffrey R Boris | Pediatrics | 3401 Civic Center Blvd, Children's Hospital of Philadelphia - Cardiology, Philadelphia, PA 19104-4319 | 2005-06-23 |
| 1306480389 | Stc Pediatrics LLC | Pediatrics | 160 E Erie Ave, Philadelphia, PA 19134-1011 | 2019-11-01 |
| 1326550534 | Michaela Elizabeth Mccrudden | Pediatrics | 160 E Erie Ave, Philadelphia, PA 19134-1011 | 2017-10-27 |
| 1346771359 | Jill Hsia | Pediatrics | 3401 Civic Center Blvd, Philadelphia, PA 19104-4319 | 2017-03-22 |
| 1891145611 | Ari Gartenberg | Pediatrics | 3401 Civic Center Blvd, Division of Cardiology, Philadelphia, PA 19104-4319 | 2016-06-14 |
| 1396195103 | Alicia Mcdonnell Kamsheh | Pediatrics | 3401 Civic Center Blvd, Division of Cardiology, Philadelphia, PA 19104-4319 | 2016-06-13 |
| 1154785590 | Sheri Balsara | Pediatrics | 3401 Civic Center Blvd, Philadelphia, PA 19104-4319 | 2016-04-12 |
| 1942695721 | Travus James White | Pediatrics | 3401 Civic Center Blvd, Division of Cardiology, Philadelphia, PA 19104 | 2015-03-30 |
| Find all providers in PHILADELPHIA | ||||
| City | PHILADELPHIA |
| Zip Code | 19104 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.