Individual provider Active NPI

Mark A Dipillo, M.D.

  • Ophthalmology Physician
  • Wyomissing, PA
National Provider Identifier
1073583902
Registry record updated Aug 9, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
288686 Issued in MA
Practice address
2630 Westview Dr
Wyomissing, PA 19610-1130
Phone
(610) 376-1981
Fax
(610) 376-3153
NPI assigned
Jan 24, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 9, 2021

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X MD044541E PA
Ophthalmology Physician 207W00000X 288686 MA Primary
Glaucoma Specialist (Ophthalmology) Physician 207WX0009X MD044541E PA

Addresses

Primary practice location

2630 Westview Dr
Wyomissing, PA 19610-1130

Mailing address

2630 Westview Dr
Wyomissing, PA 19610-1130
Phone (610) 376-1981

Other identifiers 2

IdentifierTypeStateIssuer
1415500MedicaidPA
180026325OtherPARAILROAD MEDICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
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
I20210831002770 MA Practitioner - Ophthalmology 6305846056 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Ophthalmology
Education
New York University School of Medicine, 1983
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Berkshire Eye Center PCGroup PAC ID 6901844802, 9 clinicians

Practice addresses (Care Compare)

740 Williams St
Pittsfield, MA 01201-7463
Phone (413) 445-4564

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery127

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD044541EPAMDGlaucoma Specialist (Ophthalmology) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Berkshire Eye Center PC Ophthalmology CurrentSince Oct 18, 2021 Accepting new patients

Locations

740 Williams St
Pittsfield, MA 01201
Phone (413) 445-4564

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": "1138060800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1628467200000",
    "number": "1073583902",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2630 WESTVIEW DR",
            "city": "WYOMISSING",
            "state": "PA",
            "postal_code": "196101130",
            "telephone_number": "610-376-1981",
            "fax_number": "610-376-3153"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2630 WESTVIEW DR",
            "city": "WYOMISSING",
            "state": "PA",
            "postal_code": "196101130",
            "telephone_number": "610-376-1981",
            "fax_number": "610-376-3153"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIPILLO",
        "first_name": "MARK",
        "middle_name": "A",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-24",
        "last_updated": "2021-08-09",
        "certification_date": "2021-08-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "PA",
            "license": "MD044541E",
            "primary": false
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "MA",
            "license": "288686",
            "primary": true
        },
        {
            "code": "207WX0009X",
            "taxonomy_group": "",
            "desc": "Ophthalmology, Glaucoma Specialist",
            "state": "PA",
            "license": "MD044541E",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1415500",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "180026325",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wyomissing, PA

Sources for this page

Verify at the official NPI Registry.