Individual provider Active NPI

Richard Michael Dimonte Jr., D.O.

  • General Practice Physician
  • Media, PA
National Provider Identifier
1497863518
Registry record updated Dec 29, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
OS008967L Issued in PA
Practice address
112 W Front St
Media, PA 19063-3208
Phone
(610) 566-1881
Fax
(610) 566-4776
NPI assigned
Aug 28, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 29, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X OS008967L PA
General Practice Physician 208D00000X OS008967L PA Primary

Addresses

Primary practice location

112 W Front St
Media, PA 19063-3208

Mailing address

112 W Front St
Media, PA 19063-3208
Phone (610) 566-1881

Other identifiers 1

IdentifierTypeStateIssuer
01618989MedicaidPA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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

Enrollment IDStateProvider typePAC IDDetails
I20040505000451 PA Practitioner - Family Practice 2365430683

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
OS008967LPAMDGeneral Practice Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Lima Gerontology Associates LLP CurrentSince Mar 1, 2012 Accepting new patients

Locations

340 N Middletown Rd
Media, PA 19063
Phone (610) 565-7810

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1156723200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1609200000000",
    "number": "1497863518",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "112 W FRONT ST",
            "city": "MEDIA",
            "state": "PA",
            "postal_code": "190633208",
            "telephone_number": "610-566-1881",
            "fax_number": "610-566-4776"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "112 W FRONT ST",
            "city": "MEDIA",
            "state": "PA",
            "postal_code": "190633208",
            "telephone_number": "610-566-1881",
            "fax_number": "610-566-4776"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIMONTE",
        "first_name": "RICHARD",
        "middle_name": "MICHAEL",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-28",
        "last_updated": "2020-12-29",
        "certification_date": "2020-12-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "PA",
            "license": "OS008967L",
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "PA",
            "license": "OS008967L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01618989",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Media, PA

Sources for this page

Verify at the official NPI Registry.