David James Dimitroff Jr., M.D.

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

01083263A Issued in IN

Practice address

1610 Calumet Ave Ste B
Valparaiso, IN 46383-3328

Phone

(219) 462-4655

Fax

(219) 462-2491

NPI assigned

Mar 21, 2017

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: david.dimitroff@577908282753028.direct.elationemr.com

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.

• Noah's Ark Pediatrics LLC

  • Pediatrics Physician
  • Valparaiso, IN
  • NPI 1336843051
  NPD Authorized official

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

{
    "created_epoch": "1490054400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1683676800000",
    "number": "1083145171",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1610 CALUMET AVE STE B",
            "city": "VALPARAISO",
            "state": "IN",
            "postal_code": "463833328",
            "telephone_number": "219-462-4655",
            "fax_number": "219-462-2491"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1610 CALUMET AVE STE B",
            "city": "VALPARAISO",
            "state": "IN",
            "postal_code": "463833328",
            "telephone_number": "219-462-4655",
            "fax_number": "219-462-2491"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIMITROFF",
        "first_name": "DAVID",
        "middle_name": "JAMES",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-03-21",
        "last_updated": "2023-05-10",
        "certification_date": "2023-05-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "IN",
            "license": "01083263A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Oliver Pimentel Diamante, M.D
• Nancy A Dickey, AU.D.
• Patrick Dickinson, CRNA
• Stephanie M Didion
• Digestive Healthcare Associates, P.C.
• Samantha Disney
• Linda Dispensa
• Robert C Ditto, RN
• Mark Dixon, D.O.
• Daniel David Doan, LMHC

• Pediatrics Physician in Valparaiso, IN
• Providers in Valparaiso, IN by specialty
• Pediatrics Physician in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 10, 2023; 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.

Verify at the official NPI Registry.