Ivan G Dimich, M.D.

Primary specialty

Pediatric Cardiology PhysicianTaxonomy code 2080P0202X

License

1045571 Issued in NY

Practice address

201East79Thstreetsuite
20 E
New York, NY 10075-0836

Phone

(212) 734-8232

NPI assigned

Mar 9, 2010

Sex

Male

Sole proprietor

Yes

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 NY

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": "1268092800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1268092800000",
    "number": "1134442999",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "201EAST79THSTREETSUITE20E",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100750836",
            "telephone_number": "212-734-8232"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201EAST79THSTREETSUITE",
            "address_2": "20 E",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100750836",
            "telephone_number": "212-734-8232"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIMICH",
        "first_name": "IVAN",
        "middle_name": "G",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-03-09",
        "last_updated": "2010-03-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0202X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Cardiology",
            "state": "NY",
            "license": "1045571",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ellen Dimeglio, PSYD
• Samantha Maria Dimeglio, PSYD
• Christopher A Dimeo, MD
• Rosemary Dimicelli, DENTAL HYGIENIST
• Alexandra B Dimich, MD
• Donna Dimichele, MD
• Mary Jo Dimilia, M.D.
• Samantha Elizabeth Dimisa, PH.D.
• Elisabeth Dimitratos, PA
• Diana Maria Dimitri, PH.D.

• Pediatric Cardiology Physician in New York, NY
• Providers in New York, NY by specialty
• Pediatric Cardiology Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 9, 2010; 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.