Richard D. Dibacco, DPM

Primary specialty

Foot Surgery PodiatristTaxonomy code 213ES0131X

License

SC001282L Issued in PA

Practice address

4402 Peach St
Erie, PA 16509-1358

Phone

(814) 864-4874

Fax

(814) 864-4877

NPI assigned

Feb 8, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 4

Addresses

Other identifiers 1

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: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Podiatry

Education

Kent State University College of Podiatric Medicine, 1967

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• Podiatry Associates of Erie Inc

  • Foot Surgery Podiatrist
  • Erie, PA
  • NPI 1952423857
  Medicare reassignment Authorized official

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

{
    "created_epoch": "1139356800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1277856000000",
    "number": "1609849934",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4402 PEACH ST",
            "city": "ERIE",
            "state": "PA",
            "postal_code": "165091358",
            "telephone_number": "814-864-4874",
            "fax_number": "814-864-4877"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4402 PEACH ST",
            "city": "ERIE",
            "state": "PA",
            "postal_code": "165091358",
            "telephone_number": "814-864-4874",
            "fax_number": "814-864-4877"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIBACCO",
        "first_name": "RICHARD",
        "middle_name": "D.",
        "name_prefix": "Dr.",
        "credential": "DPM",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-02-08",
        "last_updated": "2010-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213EP1101X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Primary Podiatric Medicine",
            "state": "PA",
            "license": "SC001282L",
            "primary": false
        },
        {
            "code": "213ER0200X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Radiology",
            "state": "PA",
            "license": "SC001282L",
            "primary": false
        },
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "PA",
            "license": "SC001282L",
            "primary": false
        },
        {
            "code": "213ES0131X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot Surgery",
            "state": "PA",
            "license": "SC001282L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000501005-0001",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Janice Di Luzio, PH. D.
• Diagnostic X-Ray Service, Inc.
• Diagnostic X-Ray Service, Inc.
• Diamonds Enterprise Health Services,LLC
• Lauren Dibacco
• Cheryl J. Dickson, CRNA
• Kellilynn Marie Dickson
• William Diefenbach
• David F. Dieteman, M.D.
• Brande Dietrich-McLean, CRNP

• Foot Surgery Podiatrist in Erie, PA
• Providers in Erie, PA by specialty
• Foot Surgery Podiatrist in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2010; 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.