Charles L Dietzek, DO, Facos, PC
NPI 1306905658ActiveOrganization· Surgery, Vascular Surgery· Voorhees, NJ
Surgery, Vascular Surgery in Voorhees, New Jersey, registered in NPPES in December 2006. The authorized official on file is Delores Debruce, Practice Manager. Enrolled in Medicare as part b supplier - clinic/group practice.
Overview
| NPI | 1306905658 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Dec 6, 2006 |
| Last updated in NPPES | Oct 26, 2026 |
| Certified by provider | Oct 26, 2026 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Surgery, Vascular Surgery Primary | 2086S0129X | — | — |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Part B Supplier - Clinic/Group Practice (NJ) |
|---|
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