Individual provider Active NPI

Christian Paul Dibiase, PA-C

  • Physician Assistant
  • North Miami, FL
National Provider Identifier
1114705522
Registry record updated Sep 18, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
1900 Sans Souci Blvd Apt 207
North Miami, FL 33181-3053
Phone
(518) 852-7939
NPI assigned
Sep 18, 2023
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 18, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X Primary

Addresses

Primary practice location

1900 Sans Souci Blvd Apt 207
North Miami, FL 33181-3053

Mailing address

1900 Sans Souci Blvd Apt 207
North Miami, FL 33181-3053
Phone (518) 852-7939

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241014000790 MA Practitioner - Physician Assistant 1153853361 Reassigns benefits to 6 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Bid-Milton Physician Associates Inc CurrentSince Feb 16, 2024 Accepting new patients
Associated Physicians of Harvard Medical Faculty Physicians at Beth Is CurrentSince Feb 16, 2024 Accepting new patients
Associated Physicians of Harvard Medical Faculty Physicians at Beth Is CurrentSince Feb 16, 2024 Accepting new patients
Harvard Medical Faculty Phys at Beth Israel Deaconess Med Ctr Inc Current Accepting new patients
Harvard Medical Faculty Phys at Beth Israel Deaconess Med Ctr Inc CurrentSince Feb 16, 2024 Accepting new patients
Harvard Medical Faculty Phys at Beth Israel Deaconess Med Ctr Inc CurrentSince Oct 1, 2025 Accepting new patients

Locations

1 Deaconess Rd
Boston, MA 02215
Phone (617) 754-2323

330 Brookline Ave
Boston, MA 02215
Phone (617) 667-2000

910 Washington St
Dedham, MA 02026
Phone (781) 431-1333

199 Reedsdale Rd
Milton, MA 02186
Phone (617) 313-1000

100 Highland St
Milton, MA 02186
Phone (617) 615-4000

101 Page St
New Bedford, MA 02740
Phone (508) 961-5425

Organizations & group practices 8

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": "1694995200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1694995200000",
    "number": "1114705522",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1900 SANS SOUCI BLVD APT 207",
            "city": "NORTH MIAMI",
            "state": "FL",
            "postal_code": "331813053",
            "telephone_number": "518-852-7939"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1900 SANS SOUCI BLVD APT 207",
            "city": "NORTH MIAMI",
            "state": "FL",
            "postal_code": "331813053",
            "telephone_number": "518-852-7939"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIBIASE",
        "first_name": "CHRISTIAN",
        "middle_name": "PAUL",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-09-18",
        "last_updated": "2023-09-18",
        "certification_date": "2023-09-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in North Miami, FL

Sources for this page

Verify at the official NPI Registry.