Stephen Lee Diblasi, DO

Primary specialty

Cardiovascular Disease PhysicianTaxonomy code 207RC0000X

License

1803 Issued in WV

Practice address

4315 Maccorkle Ave SE
Charleston, WV 25304-2503

Phone

(304) 926-8080

Fax

(304) 926-8083

NPI assigned

Oct 19, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy, Doctor of Medicine

State licenses

Practice roles

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.

• CC Smith MD Inc

  • Internal Medicine Physician
  • Sandusky, OH
  • NPI 1922092592
  NPD (past)
• Southeastern Cardiology

  • Cardiovascular Disease Physician
  • Vidalia, GA
  • NPI 1396944633
  NPD (past)

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

{
    "created_epoch": "1129680000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1418342400000",
    "number": "1609865930",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4315 MACCORKLE AVE SE",
            "city": "CHARLESTON",
            "state": "WV",
            "postal_code": "253042503",
            "telephone_number": "304-926-8080",
            "fax_number": "304-926-8083"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4315 MACCORKLE AVE SE",
            "city": "CHARLESTON",
            "state": "WV",
            "postal_code": "253042503",
            "telephone_number": "304-926-8080",
            "fax_number": "304-926-8083"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIBLASI",
        "first_name": "STEPHEN",
        "middle_name": "LEE",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-19",
        "last_updated": "2014-12-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "GA",
            "license": "053388",
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "WV",
            "license": "1803",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "471776680A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Harshitha Dhanpalreddy, MBBS
• Italo Alejandro Di Prisco, D.D.S
• Diabetes Concepts by Javins, Inc
• Diana Masso Dba Counseling Advantage
• Richard Diaz
• Anthony Dick
• Stephanie Dick
• Angela Dickens
• Michelle Louise Dickens
• Danny Dickerson, BS

• Cardiovascular Disease Physician in Charleston, WV
• Providers in Charleston, WV by specialty
• Cardiovascular Disease Physician in West Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 12, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.