Individual provider Active NPI

Ralph R Dimattia, MD

  • Internal Medicine Physician
  • Williamsburg, VA
National Provider Identifier
1013985068
Registry record updated Sep 12, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
0101036830 Issued in VA
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

Updated by the provider on Sep 12, 2013

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
010026253MedicaidVA

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040113000244 VA Practitioner - HospitalistPractitioner - Internal Medicine 5698675882 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
0101036830VAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Sentara Medical Group Internal Medicine CurrentSince Dec 1, 2003 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

Verify at the official NPI Registry.