Individual provider Active NPI

Donald J. Dipette, M.D.

  • Internal Medicine Physician
  • Columbia, SC
National Provider Identifier
1194784686
Registry record updated Jul 2, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
30302 Issued in SC
Practice address
1801 Sunset Dr
Columbia, SC 29203-6803
Phone
(803) 434-4100
Fax
(803) 434-4155
NPI assigned
Mar 22, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 2, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 30302 SC Primary
Internal Medicine Physician 207R00000X G9732 TX

Addresses

Primary practice location

1801 Sunset Dr
Columbia, SC 29203-6803

Mailing address

PO Box 743904
Atlanta, GA 30374-3904
Phone (803) 293-7320

Other identifiers 5

IdentifierTypeStateIssuer
303022MedicaidSC
8F5572OtherTXBLUE SHIELD
1298481-06MedicaidTX
110234826OtherTXRR/MEDICARE
1298481-08OtherTXCSHCN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC
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
I20120207000310 SC Practitioner - Internal Medicine 8820255631 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Pennsylvania State University College of Medicine, 1977
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Prisma Health Medical Group-MidlandsGroup PAC ID 5991099707, 1,040 clinicians

Practice addresses (Care Compare)

2 Medical Park Rd
Suite 501
Columbia, SC 29203-6839
Phone (803) 540-1000

Hospital & facility affiliations

  • Prisma Health Richland Hospital Hospital, Columbia, SC, CCN 420018

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
30302SCMDInternal Medicine Physician
G9732TXMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Prisma Health Medical Group-Midlands CurrentSince Sep 11, 2016 Accepting new patients
Prisma Health Medical Group-Midlands Internal Medicine CurrentSince Sep 11, 2016 Accepting new patients

Locations

1801 Sunset Dr
Columbia, SC 29203
Phone (803) 434-4153

2 Medical Park Rd
Ste 506
Columbia, SC 29203
Phone (803) 434-3930

2 Medical Park Rd
Ste 501
Columbia, SC 29203
Phone (803) 434-3320

Organizations & group practices 2

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.

Hospital & facility affiliations 7

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

NPI Registry JSON

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

{
    "created_epoch": "1142985600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1625184000000",
    "number": "1194784686",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 743904",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303743904",
            "telephone_number": "803-293-7320",
            "fax_number": "803-293-7330"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1801 SUNSET DR",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292036803",
            "telephone_number": "803-434-4100",
            "fax_number": "803-434-4155"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIPETTE",
        "first_name": "DONALD",
        "middle_name": "J.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-22",
        "last_updated": "2021-07-02",
        "certification_date": "2021-07-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "SC",
            "license": "30302",
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TX",
            "license": "G9732",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "303022",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "8F5572",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1298481-06",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR/MEDICARE",
            "identifier": "110234826",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CSHCN",
            "identifier": "1298481-08",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbia, SC

Sources for this page

Verify at the official NPI Registry.