Mr John Brett Dietze, MD - Medicare Neurosurgery in Texarkana, TX

Mr John Brett Dietze, MD is a medicare enrolled "Neurological Surgery" physician in Texarkana, Texas. He went to University Of Texas Southwestern Medical School At Dallas and graduated in 1994 and has 30 years of diverse experience with area of expertise as Neurosurgery. He is a member of the group practice Ir Rehab, P.c., Providence Health Alliance and his current practice location is 2602 Saint Michael Dr Ste 302b, Texarkana, Texas. You can reach out to his office (for appointments etc.) via phone at (903) 794-4196.

Mr John Brett Dietze is licensed to practice in Texas (license number K2152) and he also participates in the medicare program. He accepts medicare assignments (which means he accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and his NPI Number is 1588665319.

Contact Information

Mr John Brett Dietze, MD
2602 Saint Michael Dr Ste 302b,
Texarkana, TX 75503-5228
(903) 794-4196
(903) 614-5169



Physician's Profile

Full NameMr John Brett Dietze
GenderMale
SpecialityNeurosurgery
Experience30 Years
Location2602 Saint Michael Dr Ste 302b, Texarkana, Texas
Accepts Medicare AssignmentsYes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance.
  Medical Education and Training:
  • Mr John Brett Dietze attended and graduated from University Of Texas Southwestern Medical School At Dallas in 1994
  NPI Data:
  • NPI Number: 1588665319
  • Provider Enumeration Date: 08/02/2005
  • Last Update Date: 04/28/2021
  Medicare PECOS Information:
  • PECOS PAC ID: 6709789308
  • Enrollment ID: I20051215000733

Medical Identifiers

Medical identifiers for Mr John Brett Dietze such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1588665319NPI-NPPES
1G1885OtherTXMEDICARE
141100101OtherINDIGENT HEALTH CARE
18796000000OtherARQUALCHOICE OF ARKANSAS
98601OtherTXCOLLUM & CARNEY CLINIC
98601OtherARBLUE CROSS
179117500OtherUS DEPT OF LABOR
1871793307OtherTXCIGNA DME
8A0896OtherTXBLUE CROSS
140006859OtherTXRAILROAD MEDICARE
141100101MedicaidTX
142238001MedicaidAR
200023040AMedicaidOK
5575000001OtherTXCIGNA GOVERNMENT SERVICES
MDK2152OtherTXWORKERS' COMPENSATION
98601OtherFIRST PYRAMID LIFE

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
207T00000XNeurological Surgery K2152 (Texas)Primary

Medical Facilities Affiliation

Facility NameLocationFacility Type
Providence Health CenterWaco, TXHospital

Group Practice Association

Group Practice NameGroup PECOS PAC IDNo. of Members
Ir Rehab, P.c.1153453691121
Providence Health Alliance6305731068129

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Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Mr John Brett Dietze allows following entities to bill medicare on his behalf.
Entity NameChristus Trinity Clinic
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1285684225
PECOS PAC ID: 3072426741
Enrollment ID: O20031204001091

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Entity NameProvidence Health Alliance
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1932210838
PECOS PAC ID: 6305731068
Enrollment ID: O20040220000307

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Entity NameC H Wilkinson Physician Network
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1457382947
PECOS PAC ID: 8921919580
Enrollment ID: O20041203000584

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Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Mr John Brett Dietze is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Mr John Brett Dietze, MD
P O Box 9600, Dept 09-019,
Texarkana, TX 75505-9600

Ph: (903) 794-4196
Mr John Brett Dietze, MD
2602 Saint Michael Dr Ste 302b,
Texarkana, TX 75503-5228

Ph: (903) 794-4196

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Neurological Surgery Doctors in Texarkana, TX

Dr. Jason Robert Hall, M.D.
Neurological Surgery
Medicare: Accepting Medicare Assignments
Practice Location: 2602 Saint Michael Dr Ste 302b, Texarkana, TX 75503
Phone: 903-614-5180    Fax: 903-614-5166
Ricardo Cortez,
Neurological Surgery
Medicare: Accepting Medicare Assignments
Practice Location: 2602 Saint Michael Dr, Texarkana, TX 75503
Phone: 903-794-4196    
Mr. Freddie L Contreras, MD
Neurological Surgery
Medicare: Accepting Medicare Assignments
Practice Location: 1002 Texas Blvd, Ste 406, Texarkana, TX 75501
Phone: 903-794-4196    Fax: 903-792-7408
Brian Keith Willis, M.D.
Neurological Surgery
Medicare: Accepting Medicare Assignments
Practice Location: 1002 Texas Blvd Ste 406, Texarkana, TX 75501
Phone: 903-794-4196    Fax: 903-792-7408

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