Individual provider Active NPI

Domenic Dibartolomeo, M.D.

  • Emergency Medicine Physician
  • Chicago, IL
National Provider Identifier
1083978084
Registry record updated Jun 25, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
125-061346 Issued in IL
Practice address
7435 W Talcott Ave
Resurrection Em Residency
Chicago, IL 60631-3707
Phone
(773) 792-7921
NPI assigned
Jun 25, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 25, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 125-061346 IL Primary

Addresses

Primary practice location

7435 W Talcott Ave
Resurrection Em Residency
Chicago, IL 60631-3707

Mailing address

7435 W Talcott Ave
Resurrection Em Residency
Chicago, IL 60631-3707

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: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180103000073 FL Practitioner - Emergency Medicine 6406177914 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
125-061346ILMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Chapters Health Palliative Care, LLC CurrentSince Oct 12, 2024 Accepting new patients
Inphynet Contracting Services LLC Emergency Medicine CurrentSince Oct 7, 2017 Accepting new patients

Locations

12470 Telecom Dr
Ste 301
Temple Terrace, FL 33637
Phone (423) 707-8678

12470 Telecom Dr
Ste 300
Temple Terrace, FL 33637
Phone (813) 871-8111

951 N Washington Ave
Titusville, FL 32796
Phone (302) 325-5511

2144 Welbilt Blvd
Trinity, FL 34655
Phone (727) 376-3658

1 Tampa General Cir
University of Tampa, FL 33606
Phone (813) 251-5822

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1340582400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1340582400000",
    "number": "1083978084",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7435 W TALCOTT AVE",
            "address_2": "RESURRECTION EM RESIDENCY",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606313707"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7435 W TALCOTT AVE",
            "address_2": "RESURRECTION EM RESIDENCY",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606313707",
            "telephone_number": "773-792-7921"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIBARTOLOMEO",
        "first_name": "DOMENIC",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-06-25",
        "last_updated": "2012-06-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "IL",
            "license": "125-061346",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.