Eugene Michael Dibetta Jr., D.O.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

OS11136 Issued in FL

Practice address

12020 Seminole Blvd
Largo, FL 33778-2805

Phone

(727) 588-9572

Fax

(727) 584-3832

NPI assigned

Sep 29, 2010

Last updated

Jun 26, 2012By 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

Medicare fee-for-service enrollment

Enrolled in FL

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

Specialty

Family PracticeAlso: Preventive Medicine

Education

Lake Erie College of Osteopathic Medicine, Erie, 2009

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Suncoast Family Medical AssociatesGroup PAC ID 0941195242, 14 clinicians

Paxton Medical ManagementGroup PAC ID 7214349737, 5 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/IIFBCD

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.

• Paxton Medical Management

  dba Family Doctors of North Port

  • Family Medicine Physician
  • North Port, FL
  • NPI 1457950420
  Medicare reassignment Care Compare group NPD
• Suncoast Family Medical Associates

  • Family Medicine Physician
  • Largo, FL
  • NPI 1811981178
  Medicare reassignment Care Compare group NPD
• G & D Partners

  dba Immediate Medcare and Family Doctors-Manatee

  • Family Medicine Physician
  • Bradenton, FL
  • NPI 1225563935
  Medicare reassignment NPD
• Grove & Dibetta PLLC

  dba Immediate Medcare and Family Doctors of Bradenton

  • Family Medicine Physician
  • Bradenton, FL
  • NPI 1497131692
  Medicare reassignment NPD
• Paxton Medical Management

  dba Family Doctors of Englewood

  • Family Medicine Physician
  • Englewood, FL
  • NPI 1134899651
  NPD
• Paxton Medical Management

  dba Sun City Senior Care

  • Family Medicine Physician
  • Sun City Center, FL
  • NPI 1588400691
  NPD

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

{
    "created_epoch": "1285718400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1340668800000",
    "number": "1467761064",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12020 SEMINOLE BLVD",
            "city": "LARGO",
            "state": "FL",
            "postal_code": "337782805",
            "telephone_number": "727-588-9572",
            "fax_number": "727-584-3832"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12020 SEMINOLE BLVD",
            "city": "LARGO",
            "state": "FL",
            "postal_code": "337782805",
            "telephone_number": "727-588-9572",
            "fax_number": "727-584-3832"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIBETTA",
        "first_name": "EUGENE",
        "middle_name": "MICHAEL",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-09-29",
        "last_updated": "2012-06-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "OS11136",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Diagnostic Clinic Medical Group, PA
• Vasilios Frank Diakonis, MD
• Megan Diamond, OTR/L
• Jesus Diaz Vera
• Angelina Diaz
• Adam S Didio, MD
• Karen Didovets, COTA
• Stephanie Dieffenthaller
• Iris Diego Portal
• Robert Digiovanni, D.O.

• Family Medicine Physician in Largo, FL
• Providers in Largo, FL by specialty
• Family Medicine Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 26, 2012; 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.