Christopher Santo Dibello, M.D.

Individual provider Active NPI Pulmonary Disease Physician · New Smyrna Beach, FL

NPI 1487875977 · NPPES record last updated Oct 12, 2012

Key facts

NPI
1487875977
Entity type
Individual (NPI type 1)
Primary specialty
Pulmonary Disease Physician 207RP1001X
License
ME107805 (FL)
Practice address
1055 N Dixie Fwy
Suite 1
New Smyrna Beach, FL 32168-6201
Phone
(386) 423-0505
Fax
(386) 423-0515
NPI assigned
May 1, 2007
Sex
Male
Sole proprietor
No

Organizations & group practices 3

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.

Hospital & facility affiliations 8

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

Owned or controlled facilities with NPI records 2

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Medicare Care Compare profile

Specialty
Pulmonary Disease
Also: Critical Care (Intensivists)
Education
State University of New York Downstate Medical Center, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
PCCC of Volusia LLC (15 clinicians)

Practice addresses (Care Compare)

1055 N Dixie Fwy
Suite 1
New Smyrna Beach, FL 32168-6201
Phone (386) 423-0505

Hospital & facility affiliations

  • Trilogy Home Healthcare Home health agency · Jacksonville, FL · CCN 107689
  • Adventhealth Deland Hospital · Deland, FL · CCN 100045
  • Adventhealth New Smyrna Beach Hospital · New Smyrna Beach, FL · CCN 100014
  • Adventhealth Daytona Beach Hospital · Daytona Beach, FL · CCN 100068
  • Adventhealth Fish Memorial Hospital · Orange City, FL · CCN 100072
  • AdventHealth Palm Coast Hospital · Palm Coast, FL · CCN 100118

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100 (individual)

Medicare participation

Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes

All facility ownership & control disclosures 2

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Adventhealth Deland
Deland, FL · CCN 100045
Hospital Corporate Director Dec 9, 2021
Adventhealth Deland
Deland, FL · CCN 10S045
Hospital Corporate Director Dec 9, 2021

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20111205000706 FL Practitioner - Pulmonary Disease
Practitioner - Critical Care (Intensivists)
3678616174 Reassigns benefits to 1 organization

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
ME107805FLMDPulmonary Disease Physician

Practice roles (3 of 5)

OrganizationSpecialtyStatusNew patients
PCCC of Volusia LLC Pulmonary Disease Current
since Apr 30, 2012
Accepting new patients
NDC of Volusia LLC Past Accepting new patients
North Brevard Medical Support, Inc Past Accepting new patients

Locations

575 N Clyde Morris Blvd
Ste B
Daytona Beach, FL 32114
Phone (386) 258-7322

638 W Plymouth Ave
Deland, FL 32720
Phone (386) 279-0006

1055 N Dixie Fwy
Ste 1
New Smyrna Beach, FL 32168
Phone (386) 423-0505

780 Dunlawton Ave
Ste 1
Port Orange, FL 32127
Phone (386) 222-6111

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

Interoperability endpoints

  • FHIR API: https://fhir-api.fhirprod.aws.greenwayhealth.com/fhir/R4/2.16.840.1.113883.3.140.71631
  • Direct secure messaging: christopher.dibello@pccc.directbygreenway.com

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Pulmonary Disease Physician 207RP1001X ME107805 FL Yes

Addresses

Primary practice location

1055 N Dixie Fwy
Suite 1
New Smyrna Beach, FL 32168-6201

Mailing address

1055 N Dixie Fwy
Suite 1
New Smyrna Beach, FL 32168-6201
Phone (386) 423-0505

Other identifiers

IdentifierTypeStateIssuer
004272900MedicaidFL

Other providers in New Smyrna Beach, FL

All providers in New Smyrna Beach, FL · Pulmonary Disease Physician in Florida

Sources for this page

Verify at the official NPI Registry.