Individual provider Active NPI

Diane M Digeronimo, LCSW

  • Clinical Social Worker
  • Melbourne Beach, FL
National Provider Identifier
1083652002
Registry record updated Nov 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
SW0002181 Issued in FL
Practice address
321 Ocean Ave Ste 107
Melbourne Beach, FL 32951-2569
Phone
(321) 230-3023
NPI assigned
Jun 3, 2006
Last updated
Nov 18, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 18, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X SW0002181 FL Primary

Addresses

Primary practice location

321 Ocean Ave Ste 107
Melbourne Beach, FL 32951-2569

Mailing address

321 Ocean Ave Ste 107
Melbourne Beach, FL 32951-2569
Phone (321) 230-3023

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110517000681 FL Practitioner - Clinical Social Worker 0749466290 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1979
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

321 Ocean Ave
Suite 107
Melbourne Beach, FL 32951-2569
Phone (321) 230-3023

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
SW0002181FLMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Diane M. Digeronimo, LCSW, PA Clinical CurrentSince Aug 11, 2010 Accepting new patients

Locations

2194 Highway A1A
Ste 203
Indian Harbour Beach, FL 32937
Phone (321) 777-8930

321 Ocean Ave
Ste 107
Melbourne Beach, FL 32951
Phone (321) 230-3023

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1149292800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731888000000",
    "number": "1083652002",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "321 OCEAN AVE STE 107",
            "city": "MELBOURNE BEACH",
            "state": "FL",
            "postal_code": "329512569",
            "telephone_number": "321-230-3023"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "321 OCEAN AVE STE 107",
            "city": "MELBOURNE BEACH",
            "state": "FL",
            "postal_code": "329512569",
            "telephone_number": "321-230-3023"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIGERONIMO",
        "first_name": "DIANE",
        "middle_name": "M",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-06-03",
        "last_updated": "2024-11-18",
        "certification_date": "2024-11-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "SW0002181",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Melbourne Beach, FL

Sources for this page

Verify at the official NPI Registry.