Jay Martin Dietrich, APN, NP-C - Medicare Nurse Practitioner in Bloomington, IL

Jay Martin Dietrich, APN, NP-C is a medicare enrolled "Nurse Practitioner" in Bloomington, Illinois. He graduated from nursing school in 2020 and has 4 years of diverse experience with area of expertise as Nurse Practitioner. He is a member of the group practice Osf Multi-specialty Group and his current practice location is 2200 E Washington St, Bloomington, Illinois. You can reach out to his office (for appointments etc.) via phone at (309) 662-3311.

Jay Martin Dietrich is licensed to practice in Illinois (license number 209021931) 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 1225629447.

Contact Information

Jay Martin Dietrich, APN, NP-C
2200 E Washington St,
Bloomington, IL 61701-4364
(309) 662-3311
Not Available



Provider's Profile

Full NameJay Martin Dietrich
GenderMale
SpecialityNurse Practitioner
Experience4 Years
Location2200 E Washington St, Bloomington, Illinois
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:
  • Jay Martin Dietrich graduated from nursing school in 2020
  NPI Data:
  • NPI Number: 1225629447
  • Provider Enumeration Date: 01/30/2021
  • Last Update Date: 01/30/2021
  Medicare PECOS Information:
  • PECOS PAC ID: 7810305646
  • Enrollment ID: I20210416000215

Medical Identifiers

Medical identifiers for Jay Martin Dietrich such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1225629447NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
363L00000XNurse Practitioner 209021931 (Illinois)Primary
163W00000XRegistered Nurse 041446858 (Illinois)Secondary

Medical Facilities Affiliation

Facility NameLocationFacility Type
St Joseph Medical CenterBloomington, ILHospital

Group Practice Association

Group Practice NameGroup PECOS PAC IDNo. of Members
Osf Multi-specialty Group36788897891543

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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. Jay Martin Dietrich allows following entities to bill medicare on his behalf.
Entity NameOsf Multi-specialty Group
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1922445527
PECOS PAC ID: 3678889789
Enrollment ID: O20150904000279

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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. Jay Martin Dietrich 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
Jay Martin Dietrich, APN, NP-C
206 Beacon Cir,
Bloomington, IL 61704-1414

Ph: (309) 502-0379
Jay Martin Dietrich, APN, NP-C
2200 E Washington St,
Bloomington, IL 61701-4364

Ph: (309) 662-3311

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Nurse Practitioner Nurses in Bloomington, IL

Theresa Kauth,
Nurse Practitioner
Medicare: Medicare Enrolled
Practice Location: 108 W Market St, Bloomington, IL 61701
Phone: 309-827-5351    Fax: 309-829-6808
Cheryl Hansen, APRN
Nurse Practitioner
Medicare: Medicare Enrolled
Practice Location: 3024 E Empire St, Bloomington, IL 61704
Phone: 309-454-4411    
Carey Harris,
Nurse Practitioner
Medicare: Accepting Medicare Assignments
Practice Location: 1701 E College Ave, Bloomington, IL 61704
Phone: 309-664-3000    Fax: 309-664-3026
Elizabeth Jeanne Robert, APN
Nurse Practitioner
Medicare: Accepting Medicare Assignments
Practice Location: 3024 E Empire St Ste A, Bloomington, IL 61704
Phone: 309-556-7800    Fax: 309-556-7804
Ms. Linda Kay Wall, A.P.N.
Nurse Practitioner
Medicare: Not Enrolled in Medicare
Practice Location: 318 W Washington St, 3rd Floor, Bloomington, IL 61701
Phone: 309-827-4014    Fax: 309-828-6626
Amy O'brien, FNP
Nurse Practitioner
Medicare: Medicare Enrolled
Practice Location: 1401 Eastland Dr, Bloomington, IL 61701
Phone: 309-661-3360    Fax: 309-661-3390
Mrs. Sonal Mukesh Patel, NP-C
Nurse Practitioner
Medicare: Accepting Medicare Assignments
Practice Location: 1701 E College Ave, Bloomington, IL 61704
Phone: 309-664-3800    

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