Active NPI
Joseph Dibenedetto Jr., MD
- Hematology & Oncology Physician
- Providence, RI
National Provider Identifier
1205820222
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Hematology & Oncology Physician
- License
- 4989
- Practice address
- 193 Waterman St
Providence, RI 02906-4014 - Phone
- (401) 351-4470
- Fax
- (401) 351-0163
- NPI assigned
- Sep 6, 2005
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Hematology & Oncology Physician | 207RH0003X | 4989 | RI | Primary |
Addresses
Primary practice location
193 Waterman St
Providence, RI 02906-4014
Mailing address
193 Waterman St
Providence, RI 02906-4014
Phone (401) 351-4470
Other identifiers 7
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 9019RIH | Other | RI | HARVARD PILGRIM HEALTH # |
| 000644 | Other | RI | BLUE CHIP ID 3 |
| 30-00103 | Other | RI | UNITED HEALTH PROVIDER # |
| 5284224 | Other | AETNA | |
| RIH9019 | Other | RI | HARVARD PILGRIM HEALTH # |
| 369-0 | Other | RI | BLUE CROSS PROVIDER # |
| 9000369 | Medicaid | RI |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4989 | RI | MD | Hematology & Oncology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1125964800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1211932800000",
"number": "1205820222",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "193 WATERMAN ST",
"city": "PROVIDENCE",
"state": "RI",
"postal_code": "029064014",
"telephone_number": "401-351-4470",
"fax_number": "401-351-0163"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "193 WATERMAN ST",
"city": "PROVIDENCE",
"state": "RI",
"postal_code": "029064014",
"telephone_number": "401-351-4470",
"fax_number": "401-351-0163"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DIBENEDETTO",
"first_name": "JOSEPH",
"name_prefix": "Dr.",
"name_suffix": "Jr.",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2005-09-06",
"last_updated": "2008-05-28",
"status": "A"
},
"taxonomies": [
{
"code": "207RH0003X",
"taxonomy_group": "",
"desc": "Internal Medicine, Hematology & Oncology",
"state": "RI",
"license": "4989",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HARVARD PILGRIM HEALTH #",
"identifier": "9019RIH",
"state": "RI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CHIP ID 3",
"identifier": "000644",
"state": "RI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UNITED HEALTH PROVIDER #",
"identifier": "30-00103",
"state": "RI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA",
"identifier": "5284224",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HARVARD PILGRIM HEALTH #",
"identifier": "RIH9019",
"state": "RI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS PROVIDER #",
"identifier": "369-0",
"state": "RI"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "9000369",
"state": "RI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Providence, RI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 28, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.