Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Katie Lee Dieterle, RPA-C, AAHIVS

Individual provider Physician Assistant · NPI 1003092370

Katie Lee Dieterle, RPA-C, AAHIVS is a Physician Assistant in Elmira, New York. Qualified in 2007, 19 years ago. Accepts Medicare assignment. Licensed in New York.

Years since qualifying
19
Licensed in
NY
In the registry since
2008
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Practice location Address checks out

600 Roe Ave Ste 1F
Elmira, NY 14905-1676
Phone: (607) 795-8161
Fax: (607) 795-8115
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 012166 (NY)

Record details

NPI number1003092370
Entity typeIndividual (Type 1)
GenderFemale
Credentials RPA-C , AAHIVS
Sole proprietorNo
NPI enumeratedJanuary 16, 2008
Last updated in NPPESNovember 10, 2023
Certification dateNovember 10, 2023

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2007 (19 years in practice)
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

Other providers in Elmira