Active NPI
Ralph R Dimattia, MD
- Internal Medicine Physician
- Williamsburg, VA
National Provider Identifier
1013985068
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- 0101036830
- Practice address
- 100 Sentara Cir
Williamsburg, VA 23188-5713 - Phone
- (757) 984-7218
- Fax
- (757) 984-7210
- NPI assigned
- Mar 8, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 0101036830 | VA | Primary |
Addresses
Primary practice location
100 Sentara Cir
Williamsburg, VA 23188-5713
Mailing address
100 Sentara Cir
Williamsburg, VA 23188-5713
Phone (757) 984-7218
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 010026253 | Medicaid | VA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in VA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0101036830 | VA | MD | Internal Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Sentara Medical Group | Internal Medicine | Current | Accepting new patients |
Locations
850 Kempsville Rd
Norfolk, VA 23502
Phone (757) 261-0162
100 Sentara Cir
#2C
Williamsburg, VA 23188
100 Sentara Cir
Williamsburg, VA 23188
Phone (678) 690-7826
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1141776000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1378944000000",
"number": "1013985068",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "100 SENTARA CIR",
"city": "WILLIAMSBURG",
"state": "VA",
"postal_code": "231885713",
"telephone_number": "757-984-7218",
"fax_number": "757-984-7210"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "100 SENTARA CIR",
"city": "WILLIAMSBURG",
"state": "VA",
"postal_code": "231885713",
"telephone_number": "757-984-7218",
"fax_number": "757-984-7210"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DIMATTIA",
"first_name": "RALPH",
"middle_name": "R",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-03-08",
"last_updated": "2013-09-12",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "VA",
"license": "0101036830",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "010026253",
"state": "VA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Williamsburg, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.