Richard Paul Dibala, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

022511 Issued in CT

Practice address

1022 Storrs Rd
Storrs Mansfield, CT 06268-2639

Phone

(860) 429-9321

Fax

(860) 429-4775

NPI assigned

Aug 31, 2006

Last updated

May 29, 2008By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 2

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

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.

• Hartford Physician Services PC

  dba Hartford Medical Group

  • Internal Medicine Physician
  • Hartford, CT
  • NPI 1164404117

  Family Medicine

  NPD (past)

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

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1212019200000",
    "number": "1407968050",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16 JACOBS HILL RD",
            "city": "MANSFIELD CENTER",
            "state": "CT",
            "postal_code": "062501650",
            "telephone_number": "860-456-2863"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1022 STORRS RD",
            "city": "STORRS MANSFIELD",
            "state": "CT",
            "postal_code": "062682639",
            "telephone_number": "860-429-9321",
            "fax_number": "860-429-4775"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIBALA",
        "first_name": "RICHARD",
        "middle_name": "PAUL",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-31",
        "last_updated": "2008-05-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CT",
            "license": "022511",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE ID",
            "identifier": "080001969",
            "state": "CT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001225119",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Zachary Cutler, DPT
• Carmel F Cuyler, LCSW
• Steven J Dauer, PH.D.
• Craig R Denegar, PT
• Laurie L Devaney, PT, ATC
• Paula Dombek
• Eastern Highlands Health District
• Bruce Nicholas Elliott, PT
• C. John Ferreri, RPH
• Janelle Rae Francisco, M.S., ATC

• Family Medicine Physician in Storrs Mansfield, CT
• Providers in Storrs Mansfield, CT by specialty
• Family Medicine Physician in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 29, 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.

Verify at the official NPI Registry.