Individual provider Active NPI

Djiby Diop, M.D.

  • Emergency Medicine Physician
  • Belleville, IL
National Provider Identifier
1164562906
Registry record updated Mar 6, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
036112709 Issued in IL
Practice address
4500 Memorial Dr
Belleville, IL 62226-5360
Phone
(618) 257-5879
Fax
(618) 257-6740
NPI assigned
Feb 8, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 6, 2024

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 036112709 IL Primary

Addresses

Primary practice location

4500 Memorial Dr
Belleville, IL 62226-5360

Mailing address

884 Calista Ridge Dr
Belleville, IL 62221-8302
Phone (774) 239-8983

Other identifiers 1

IdentifierTypeStateIssuer
P00184442OtherRAILROAD MEDICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL
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
I20100223000434 AL Practitioner - Emergency Medicine 3678524089 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036112709ILMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Nes Tennessee Inc Emergency Medicine CurrentSince Jul 29, 2019 Accepting new patients
Nes Tennessee Inc Emergency Medicine Current Accepting new patients
Nes Tennessee Inc Emergency Medicine CurrentSince Jul 29, 2019 Accepting new patients
Alabama Emergency Physician Partners, LLC Emergency Medicine Current Accepting new patients
Alabama Emergency Physician Partners, LLC Emergency Medicine CurrentSince Aug 1, 2015 Accepting new patients
Umass Memorial Medical Group Inc Emergency Medicine Past Accepting new patients

Locations

3316 Highway 280
Alexander City, AL 35010
Phone (256) 329-7100

1007 Goodyear Ave
Gadsden, AL 35903
Phone (256) 494-4000

600 S 3rd St
Gadsden, AL 35901
Phone (256) 543-5200

29 L V Stabler Dr
Greenville, AL 36037
Phone (334) 382-2676

2016 S Alabama Ave
Monroeville, AL 36460
Phone (251) 575-3111

1725 Pine St
Montgomery, AL 36106
Phone (334) 293-8000

4401 Riverchase Dr
Phenix City, AL 36867
Phone (334) 732-3000

315 W Hickory St
Sylacauga, AL 35150
Phone (256) 249-5000

7300 State Highway 121
Ste 370374
McKinney, TX 75070

Organizations & group practices 6

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": "1170892800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1709683200000",
    "number": "1164562906",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "884 CALISTA RIDGE DR",
            "city": "BELLEVILLE",
            "state": "IL",
            "postal_code": "622218302",
            "telephone_number": "774-239-8983"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4500 MEMORIAL DR",
            "city": "BELLEVILLE",
            "state": "IL",
            "postal_code": "622265360",
            "telephone_number": "618-257-5879",
            "fax_number": "618-257-6740"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIOP",
        "first_name": "DJIBY",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-08",
        "last_updated": "2024-03-06",
        "certification_date": "2024-03-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "IL",
            "license": "036112709",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00184442",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Belleville, IL

Sources for this page

Verify at the official NPI Registry.