Individual provider Active NPI

Jessica Di Nizio, D.O.

  • Family Medicine Physician
  • Yakima, WA
National Provider Identifier
1346412079
Registry record updated Feb 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
60784868 Issued in WA
Practice address
1300 N 1St St
Yakima, WA 98901
Phone
(509) 248-4510
NPI assigned
Apr 2, 2008
Last updated
Feb 7, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 7, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 2021029615 MO
Family Medicine Physician 207Q00000X 005296 AZ
Family Medicine Physician 207Q00000X 60784868 WA Primary

Addresses

Primary practice location

1300 N 1St St
Yakima, WA 98901

Mailing address

1101 Saint Hilaire Rd
Yakima, WA 98901-7900

Other practice location 1

216 W 10th Ave Ste 204
Kennewick, WA 99336-6304
Phone (509) 221-5520

Other practice location 2

348 S Main St
Suite 1A
Camp Verde, AZ 86322-7155
Phone (928) 649-6477

Other practice location 3

1806 W Lincoln Ave
Yakima, WA 98902-2473
Phone (509) 452-4520

Other identifiers 3

IdentifierTypeStateIssuer
2096345MedicaidWA
509956MedicaidAZ
Z133563OtherAZMEDICARE PTAN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
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
I20190319000764 WA Practitioner - Family Practice 0042359473 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Temple University School of Medicine, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1806 W Lincoln Ave
Yakima, WA 98902-2473
Phone (509) 452-4520

501 S 5TH Ave
Yakima, WA 98902-3550

521 E Mountain View Ave
Ellensburg, WA 98926-3865
Phone (509) 962-1414

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
005296AZMDFamily Medicine Physician
2021029615MOMDFamily Medicine Physician
60784868WAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Community Health of Central Washington Family Medicine CurrentSince Feb 1, 2023 Accepting new patients
Community Health of Central Washington CurrentSince Feb 1, 2023 Accepting new patients
RCCH Trios Health LLC Family Medicine CurrentSince Jan 1, 2019 Accepting new patients
Community Health of Central Washington Past Accepting new patients
Oracle Healthcare Family Medicine Past Accepting new patients
Community Health of Central Washington Family Medicine Past Accepting new patients
Union Gospel Mission of Yakima Wash PastSince Nov 20, 2022 Accepting new patients

Locations

521 E Mountain View Ave
Ellensburg, WA 98926
Phone (509) 962-1414

216 W 10th Ave
Ste 204
Kennewick, WA 99336
Phone (509) 221-5520

1806 W Lincoln Ave
Yakima, WA 98902
Phone (509) 452-4520

402 S 12th Ave
Yakima, WA 98902
Phone (509) 248-3263

402 S 12th Ave
Bsmt
Yakima, WA 98902

402 S 12th Ave
Ste A
Yakima, WA 98902

501 S 5th Ave
Yakima, WA 98902
Phone (509) 494-6700

Interoperability endpoints

  • Direct secure messaging: jdinizio614769@direct.ochin.org

Organizations & group practices 7

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1207094400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1675728000000",
    "number": "1346412079",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1101 SAINT HILAIRE RD",
            "city": "YAKIMA",
            "state": "WA",
            "postal_code": "989017900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1300 N 1ST ST",
            "city": "YAKIMA",
            "state": "WA",
            "postal_code": "98901",
            "telephone_number": "509-248-4510"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "216 W 10th Ave Ste 204",
            "address_purpose": "LOCATION",
            "city": "Kennewick",
            "state": "WA",
            "postal_code": "993366304",
            "country_code": "US",
            "telephone_number": "509-221-5520",
            "fax_number": "509-221-5521",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "348 S Main St",
            "address_2": "Suite 1A",
            "address_purpose": "LOCATION",
            "city": "Camp Verde",
            "state": "AZ",
            "postal_code": "863227155",
            "country_code": "US",
            "telephone_number": "928-649-6477",
            "fax_number": "928-567-7172",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1806 W Lincoln Ave",
            "address_purpose": "LOCATION",
            "city": "Yakima",
            "state": "WA",
            "postal_code": "989022473",
            "country_code": "US",
            "telephone_number": "509-452-4520",
            "fax_number": "509-452-5224",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DI NIZIO",
        "first_name": "JESSICA",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-04-02",
        "last_updated": "2023-02-07",
        "certification_date": "2023-02-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MO",
            "license": "2021029615",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AZ",
            "license": "005296",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WA",
            "license": "60784868",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2096345",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "509956",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "Z133563",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Yakima, WA

Sources for this page

Verify at the official NPI Registry.