John Eldred Disiere, M.D.

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

C42437 Issued in CA

Practice address

3116 Harrison Ave
Eureka, CA 95503-5638

Phone

(707) 444-3885

Fax

(707) 444-7843

NPI assigned

Feb 7, 2006

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

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

{
    "created_epoch": "1139270400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1624924800000",
    "number": "1104898675",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3116 HARRISON AVE",
            "city": "EUREKA",
            "state": "CA",
            "postal_code": "955035638",
            "telephone_number": "707-444-3885",
            "fax_number": "707-444-7843"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3116 HARRISON AVE",
            "city": "EUREKA",
            "state": "CA",
            "postal_code": "955035638",
            "telephone_number": "707-444-3885",
            "fax_number": "707-444-7843"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DISIERE",
        "first_name": "JOHN",
        "middle_name": "ELDRED",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-07",
        "last_updated": "2021-06-29",
        "certification_date": "2021-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "CA",
            "license": "C42437",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Antonia Forsyth Diller, DC
• Jennifer Diane Diller
• Tara Dillon
• Ijeoma Dinneya-George, BSN, PHN, RN-BC
• Dinsmores Inpatient Services a Medical Corporation
• Leslie Angela Dixon, RN
• Peter DO, PA
• Rebecca Doane Dixon
• Christopher Allen Doane, M.A.
• Robyn Dobbs

• Surgery Physician in Eureka, CA
• Providers in Eureka, CA by specialty
• Surgery Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 29, 2021; 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.