Dominic Theodore Diciro, MD

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

2012003239 Issued in MO

Practice address

1321 Colby Ave
Everett, WA 98201-1665

Phone

(425) 261-2000

NPI assigned

May 18, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in CA, MO, WV, TX4 enrollments

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 4

Specialty

Emergency Medicine

Education

Other, 1992

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Sikeston Emergency Group LLCGroup PAC ID 6305112814, 19 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Missouri Delta Medical Center Hospital, Sikeston, MO, CCN 260113

Merit-based Incentive Payment System (MIPS)

Final score

91.05 of 100Reported as group

Quality

65.2

Improvement activities

40

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Sikeston Emergency Group LLC

  • Emergency Medicine Physician
  • Sikeston, MO
  • NPI 1427575299
  Medicare reassignment Care Compare group NPD
• Camden Emergency Group LLC

  • Emergency Medicine Physician
  • Osage Beach, MO
  • NPI 1003181637
  Medicare reassignment NPD
• Rosebud Indian Health Service

  • General Acute Care Hospital
  • Rosebud, SD
  • NPI 1194757369

  TX

  Medicare reassignment NPD
• San Francisco Physicians International Medical Group, Inc

  • Emergency Medicine Physician
  • San Ramon, CA
  • NPI 1841220720
  Medicare reassignment NPD
• Southeastern Emergency Physicians of Memphis LLC

  • Emergency Medicine Physician
  • Alton, IL
  • NPI 1437105277

  MO

  Medicare reassignment NPD
• Team Physicians of California Medical Group Inc

  • Emergency Medicine Physician
  • Delano, CA
  • NPI 1447288345
  Medicare reassignment NPD
• Rosebud Indian Health Service

  • Ambulatory Surgical Clinic/Center
  • Rosebud, SD
  • NPI 1790955128
  NPD
• North Sound Emergency Medicine PC

  • Emergency Medicine Physician
  • Everett, WA
  • NPI 1114937919
  NPD (past)
• California Em-I Medical Services, a Medical Corporation

  • Emergency Medicine Physician
  • Lake Isabella, CA
  • NPI 1053360156
  NPD (past)
• Southeastern Emergency Physicians of Memphis LLC

  • Emergency Medicine Physician
  • Pleasanton, CA
  • NPI 1114309168
  NPD (past)

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

• Missouri Delta Medical Center

  • General Acute Care Hospital
  • Sikeston, MO
  • NPI 1831269539
  Care Compare affiliation

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

{
    "created_epoch": "1147910400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1650326400000",
    "number": "1376596981",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7804 167TH ST SE",
            "city": "SNOHOMISH",
            "state": "WA",
            "postal_code": "982966323"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1321 COLBY AVE",
            "city": "EVERETT",
            "state": "WA",
            "postal_code": "982011665",
            "telephone_number": "425-261-2000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1008 N Main St",
            "address_purpose": "LOCATION",
            "city": "Sikeston",
            "state": "MO",
            "postal_code": "638015044",
            "country_code": "US",
            "telephone_number": "573-471-1600",
            "fax_number": "573-472-7606",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DICIRO",
        "first_name": "DOMINIC",
        "middle_name": "THEODORE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-18",
        "last_updated": "2022-04-19",
        "certification_date": "2022-04-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "KY",
            "license": "31881",
            "primary": false
        },
        {
            "code": "207PE0004X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine, Emergency Medical Services",
            "state": "WA",
            "license": "MD000045375",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "MO",
            "license": "2012003239",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8436651",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• George A. Diaz, MD
• Isabella Diaz
• Mike Diaz
• Mekdes Badelew Dibabie, BSN, RN
• Shelly Ann Dibiase, P.T.
• Janice Marie Dickason, P.T.
• David Dickey, MD
• Kenneth Dickinson
• William E. Dickinson, DO
• Randall C Dickson, PAC

• Emergency Medicine Physician in Everett, WA
• Providers in Everett, WA by specialty
• Emergency Medicine Physician in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 19, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.