Paula Jean Dibenedetto, ARNP
Individual provider Active NPI Gerontology Nurse Practitioner · Quitman, TX
NPI 1457726085 · NPPES record last updated Dec 30, 2024
Key facts
- NPI
- 1457726085
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Gerontology Nurse Practitioner 363LG0600X
- License
- 1077692 (TX)
- Practice address
- 117 N Winnsboro St
Quitman, TX 75783-2144 - Phone
- (037) 636-2209
- NPI assigned
- Dec 8, 2015
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 12
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2014
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Quitman Hospital LLC
Practice addresses (Care Compare)
117 N Winnsboro St
Quitman, TX 75783-2144
Phone (903) 763-6220
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in TX
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20241203001826 | TX | Practitioner - Nurse Practitioner | 9032416524 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Etmc Physician Group Inc. | Current |
Accepting new patients | |
| Etmc Physician Group Inc. | Current |
Accepting new patients | |
| Pophealthcare, LLC | Past | Accepting new patients | |
| Radiology Associates of North Texas PA | Past | Accepting new patients | |
| Quitman Hospital LLC | Past | Accepting new patients | |
| Tallahassee Medical Center, Inc. | Past | Accepting new patients |
Locations
18118 FM 344 W
Flint, TX 75762
Phone (903) 825-3292
117 N Winnsboro St
Quitman, TX 75783
Phone (903) 763-4505
Interoperability endpoints
- pdibenedetto1262220@ahs.direct-ci.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Gerontology Nurse Practitioner | 363LG0600X | 1077692 | TX | Yes |
Addresses
Primary practice location
117 N Winnsboro St
Quitman, TX 75783-2144
Mailing address
117 N Winnsboro St
Quitman, TX 75783-2144
Phone (037) 636-2209
Other providers in Quitman, TX
- Christus Trinity Clinic Texas
- Tara Clanton
- Courtney Taylor Crawford
- David Nichols
- Jimmy Davis
- James Dee Dopson Jr.
- East Texas Medical Center
- East Texas Medical Center Healthcare Associates
- East Texas Medical Center Quitman
- East Texas Medical Center Quitman
All providers in Quitman, TX · Gerontology Nurse Practitioner in Texas
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 30, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.