Mariah Marie Diercks, PT, DPT
NPI 1659971554ActiveIndividual· Physical Therapist· Red Wing, MN
Physical Therapist (PT, DPT) in Red Wing, Minnesota, licensed in MN and WI, with an NPI issued in October 2020. Enrolled in Medicare as practitioner - physical therapist in private practice.
Overview
| NPI | 1659971554 |
|---|---|
| Status | Active |
| Entity type | Individual |
| Credential | PT, DPT |
| Sole proprietor | No |
| NPI issued | Oct 29, 2020 |
| Last updated in NPPES | Jan 23, 2024 |
| Certified by provider | Jan 23, 2024 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Physical Therapist Primary | 225100000X | 12113 | MN |
| Physical Therapist | 225100000X | 15269-24 | WI |
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 Practitioner - Physical Therapist in Private Practice (MN) |
|---|
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