Diely Pichardo, MD

Primary specialty

Hematology & Oncology PhysicianTaxonomy code 207RH0003X

License

ME91834 Issued in FL

Practice address

1430 S Pine St
Melbourne, FL 32901-3119

Phone

(321) 952-0898

Fax

(321) 722-1342

NPI assigned

Dec 19, 2005

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

Other identifiers 6

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: diely.pichardo@cccb.ikm.direct-ci.com

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.

• Cancer Care Centers of Brevard Inc

  • Specialist
  • Sebastian, FL
  • NPI 1013176940
  NPD
• Cancer Care Centers of Brevard Inc

  • Specialist
  • Melbourne, FL
  • NPI 1467551762
  NPD

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

{
    "created_epoch": "1134950400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1546819200000",
    "number": "1194701573",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 534595",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303534595",
            "telephone_number": "321-255-2606",
            "fax_number": "321-255-2807"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1430 S PINE ST",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329013119",
            "telephone_number": "321-952-0898",
            "fax_number": "321-722-1342"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1048 Harvin Way",
            "address_purpose": "LOCATION",
            "city": "Rockledge",
            "state": "FL",
            "postal_code": "329553229",
            "country_code": "US",
            "telephone_number": "321-636-2111",
            "fax_number": "321-636-7180",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PICHARDO",
        "first_name": "DIELY",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-12-19",
        "last_updated": "2019-01-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RH0003X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "FL",
            "license": "ME91834",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WELLCARE",
            "identifier": "287612",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "3789162",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "03411",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "6000828001",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "7653665",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "272209700",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Physical Therapy Professionals, LLC
• Physician Assistant Services of Florida LLC
• Physician Associates LLC
• Physicians Optical Lab Inc
• Steven D Picerne, M.D.
• Jessebelle Pichardo, RBT
• Paulina Pichardo, DDS
• Jennifer Picheco
• Alison Claire Pichney
• Kelly A Pickens, DPT

• All providers in Melbourne, FL
• Hematology & Oncology Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 7, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.