Devlin Alexander Dizacomo, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT304810 Issued in CA

Practice address

81557 Dr Carreon Blvd Ste C4
Indio, CA 92201-5562

Phone

(760) 347-6195

Fax

(760) 347-2849

NPI assigned

Sep 26, 2018

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in CO, SC2 enrollments

Enrollment records 2

Specialty

Physical Therapist in Private Practice

Education

Other, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Intermountain Medical Group Denver LLCGroup PAC ID 0840513552, 571 clinicians

Colorado Luna Care Physical Therapy LLCGroup PAC ID 7517363617, 210 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

81.34 of 100Reported as group

Quality

57.41

Promoting interoperability

100

Improvement activities

40

Cost

80.4

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Colorado Luna Care Physical Therapy LLC

  • Physical Therapist
  • Denver, CO
  • NPI 1891461125
  Medicare reassignment Care Compare group NPD
• Intermountain Medical Group Denver, LLC

  • Family Medicine Physician
  • Denver, CO
  • NPI 1083021083
  Medicare reassignment Care Compare group NPD
• Beaufort Orthopaedic Sports and Spine Center LLC

  • Orthopaedic Surgery Physician
  • Beaufort, SC
  • NPI 1982765160
  Medicare reassignment NPD
• Select Physical Therapy of West Denver Limited Partnership

  dba Select Physical Therapy

  • Physical Therapy Clinic/Center
  • Westminster, CO
  • NPI 1346896081
  Medicare reassignment NPD
• Beaufort Orthopaedic Sports and Spine Center LLC

  • Orthopaedic Surgery Physician
  • Bluffton, SC
  • NPI 1497412019
  NPD
• Intermountain Medical Group Denver, LLC

  dba Orthopedic Centers of Colorado - Saint Joseph

  • Sports Medicine (Orthopaedic Surgery) Physician
  • Denver, CO
  • NPI 1083598874
  NPD
• Intermountain Medical Group Denver, LLC

  dba Lowery Clinic - Primary Care

  • Family Medicine Physician
  • Denver, CO
  • NPI 1649852070
  NPD
• MVP Physical Therapy, LLC

  dba MVP Physical Therapy

  • Physical Therapist
  • Commerce City, CO
  • NPI 1326473141
  NPD
• Select Physical Therapy of West Denver Limited Partnership

  dba Select Physical Therapy

  • Physical Therapy Clinic/Center
  • Golden, CO
  • NPI 1851911325
  NPD
• Select Physical Therapy of West Denver Limited Partnership

  dba Select Physical Therapy

  • Physical Therapy Clinic/Center
  • Wheat Ridge, CO
  • NPI 1942279567
  NPD
• CV Physical Therapy, Inc.

  dba Movement For Life Physical Therapy

  • Physical Therapy Clinic/Center
  • Indio, CA
  • NPI 1013167527
  NPD (past)
• Physiotherapy Associates Inc

  dba Select Physical Therapy

  • Physical Therapy Clinic/Center
  • Thornton, CO
  • NPI 1982654190
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1537920000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707436800000",
    "number": "1023593902",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "408 HIGUERA ST STE 200",
            "city": "SAN LUIS OBISPO",
            "state": "CA",
            "postal_code": "934016135",
            "telephone_number": "805-788-0805",
            "fax_number": "805-788-0845"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "81557 DR CARREON BLVD STE C4",
            "city": "INDIO",
            "state": "CA",
            "postal_code": "922015562",
            "telephone_number": "760-347-6195",
            "fax_number": "760-347-2849"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1076 Ribaut Rd Ste 102",
            "address_purpose": "LOCATION",
            "city": "Beaufort",
            "state": "SC",
            "postal_code": "299025490",
            "country_code": "US",
            "telephone_number": "843-525-0045",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DIZACOMO",
        "first_name": "DEVLIN",
        "middle_name": "ALEXANDER",
        "name_prefix": "Dr.",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-09-26",
        "last_updated": "2024-02-09",
        "certification_date": "2024-02-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "043117",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CO",
            "license": "PTL.0018134",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "PT304810",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Beverly Jane Dierking, BHS-LLL
• Catherine Bagamasbad Dimapilis, A-GNP-C
• Pio B Dingle Jr., CDAC-II
• Reinard D Diolola, RN
• Disabled Medical Transportation Services Inc.
• Dolores J. Castro Interpreting Services Sr.
• Berly Rose Domingo
• Stacey K Douwes
• Emily Jean Downing
• Doyle R. Nick, DDS, Inc. (Indio Surgery Center)

• Physical Therapist in Indio, CA
• Providers in Indio, CA by specialty
• Physical Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 9, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.