Jaclyn Mary Dibello

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

335570-01 Issued in NY

Practice address

475 Seaview Ave
Staten Island, NY 10305-3436

Phone

(718) 226-1548

Fax

(718) 226-8447

NPI assigned

Mar 31, 2022

Sex

Female

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 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

Specialty

Emergency Medicine

Education

State University of New York at Stony Brook, School of Medicine, 2022

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

North Shore-Lij Medical PCGroup PAC ID 3375701568, 6,374 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Staten Island University Hospital Hospital, Staten Island, NY, CCN 330160

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• North Shore-Lij Medical PC

  • Urology Physician
  • Great Neck, NY
  • NPI 1053688572

  Emergency Medicine

  Medicare reassignment Care Compare group NPD
• North Shore - Lij Medical PC

  • Internal Medicine Physician
  • New Hyde Park, NY
  • NPI 1790043479
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Staten Island University Hospital

  • General Acute Care Hospital
  • Staten Island, NY
  • NPI 1407877137
  Care Compare affiliation

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

{
    "created_epoch": "1648684800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1756252800000",
    "number": "1154061638",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "475 SEAVIEW AVE",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103053436",
            "telephone_number": "718-226-1548",
            "fax_number": "718-226-8447"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "475 SEAVIEW AVE",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103053436",
            "telephone_number": "718-226-1548",
            "fax_number": "718-226-8447"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIBELLO",
        "first_name": "JACLYN",
        "middle_name": "MARY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-03-31",
        "last_updated": "2025-08-27",
        "certification_date": "2025-08-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NY",
            "license": "335570-01",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kimberly Diaz
• Lillian Ibeth Diaz, M.D.
• Maria Linda Diaz, PNP
• Nicholas Anthony Diaz, DDS
• Christina Dibella
• Arianna Dibenedetto
• Christopher Joseph Dibenedetto, FNP
• Elaina Ann Dibenedetto, LCSW
• Isabella Dibenedetto, PT
• Jennifer Diberardino, MSSPECED

• Emergency Medicine Physician in Staten Island, NY
• Providers in Staten Island, NY by specialty
• Emergency Medicine Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 2025; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.