Individual provider Active NPI

John K Dibaise, M.D.

  • Gastroenterology Physician
  • Scottsdale, AZ
National Provider Identifier
1043293434
Registry record updated Sep 10, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
33585 Issued in AZ
Practice address
13400 E Shea Blvd
Scottsdale, AZ 85259-5404
Phone
(480) 301-8000
NPI assigned
Nov 21, 2005
Last updated
Sep 10, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 10, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X 20817 NE
Gastroenterology Physician 207RG0100X 33585 AZ Primary

Addresses

Primary practice location

13400 E Shea Blvd
Scottsdale, AZ 85259-5404

Mailing address

13400 E Shea Blvd
Scottsdale, AZ 85259-5404
Phone (480) 301-8000

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address jdibaise394354@ehrdirect.mayoclinicmsg.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
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
I20050125001098 AZ Practitioner - GastroenterologyPractitioner - Internal MedicinePractitioner - Other (Physician) 9537119961 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
GastroenterologyAlso: Internal Medicine
Education
University of Nebraska College of Medicine, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Mayo Clinic ArizonaGroup PAC ID 7012829930, 1,618 clinicians

Practice addresses (Care Compare)

13400 E Shea Blvd
Scottsdale, AZ 85259-5404
Phone (480) 301-8000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
86.47 of 100Reported as group
Quality
78.27
Promoting interoperability
100
Improvement activities
40
Cost
76.62

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy52
Upper gastrointestinal (GI) endoscopy for acid reflux38

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
20817NEMDGastroenterology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mayo Clinic Arizona CurrentSince Jan 10, 2005 Accepting new patients
Mayo Clinic Arizona CurrentSince Jan 10, 2005 Accepting new patients

Locations

13400 E Shea Blvd
Scottsdale, AZ 85259

Organizations & group practices 2

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1132531200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1599696000000",
    "number": "1043293434",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13400 E SHEA BLVD",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852595404",
            "telephone_number": "480-301-8000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13400 E SHEA BLVD",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852595404",
            "telephone_number": "480-301-8000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIBAISE",
        "first_name": "JOHN",
        "middle_name": "K",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-21",
        "last_updated": "2020-09-10",
        "certification_date": "2020-09-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "NE",
            "license": "20817",
            "primary": false
        },
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "AZ",
            "license": "33585",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jdibaise394354@ehrdirect.mayoclinicmsg.org",
            "affiliation": "N",
            "address_1": "13400 E Shea Blvd",
            "city": "Scottsdale",
            "state": "AZ",
            "country_code": "US",
            "postal_code": "852595404",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Scottsdale, AZ

Sources for this page

Verify at the official NPI Registry.