Individual provider Active NPI

Frederick Dimeo, P.A.

  • Physician Assistant
  • Dover, DE
National Provider Identifier
1669479531
Registry record updated Jan 7, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
C50000194 Issued in DE
Practice address
655 S Bay Rd Ste 1F
Dover, DE 19901-4694
Phone
(302) 730-4366
Fax
(302) 730-0231
NPI assigned
Jul 6, 2005
Last updated
Jan 7, 2019By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 7, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X C50000194 DE Primary
Surgical Physician Assistant 363AS0400X C50000194 DE

Addresses

Primary practice location

655 S Bay Rd Ste 1F
Dover, DE 19901-4694

Mailing address

640 S State St
Pob BLDG--3Rd Floor
Dover, DE 19901
Phone (302) 480-1688

Other identifiers 2

IdentifierTypeStateIssuer
168809ZA5HOtherDEMEDICARE NUMBER
1000015430MedicaidDE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DE
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110414000813 DE Practitioner - Physician Assistant 4284818295 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Hahnemann University College of Medicine, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Bayhealth Medical Center, IncGroup PAC ID 1658364740, 399 clinicians

Practice addresses (Care Compare)

100 Wellness Way
Milford, DE 19963-4364
Phone (302) 744-7162

640 S State St
Dover, DE 19901-3530

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
C50000194DEMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Bayhealth Medical Center, Inc CurrentSince Jan 3, 2011 Accepting new patients
Bayhealth Medical Center, Inc CurrentSince Jan 3, 2011 Accepting new patients
Bayhealth Medical Center, Inc Past Accepting new patients
Bayhealth Medical Center, Inc Past Accepting new patients
Glen D. Rowe, D.O., P.a. Past Accepting new patients
Tamesis Rheumatology Medicine of Delaware, P.a Past Accepting new patients
Bayhealth Medical Center, Inc Past Accepting new patients

Locations

540 S Governors Ave
Ste 201
Dover, DE 19904
Phone (302) 672-4600

640 S State St
Dover, DE 19901
Phone (302) 744-4700

640 S State St
Bldg 3RD
Dover, DE 19901

640 S State St
Bldg 742
Dover, DE 19901

651 S Bay Rd
Ste 1F
Dover, DE 19901
Phone (302) 730-4366

655 S Bay Rd
Ste 1F
Dover, DE 19901
Phone (302) 730-4366

100 Wellness Way
Milford, DE 19963
Phone (302) 422-3311

18383 Hudson Rd
Ste B
Milton, DE 19968
Phone (302) 725-3499

315 N Carter Rd
Smyrna, DE 19977
Phone (302) 355-2383

Organizations & group practices 7

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.

Hospital & facility affiliations 2

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

NPI Registry JSON

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

{
    "created_epoch": "1120608000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1546819200000",
    "number": "1669479531",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "640 S STATE ST",
            "address_2": "POB BLDG--3RD FLOOR",
            "city": "DOVER",
            "state": "DE",
            "postal_code": "19901",
            "telephone_number": "302-480-1688",
            "fax_number": "302-257-5777"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "655 S BAY RD STE 1F",
            "city": "DOVER",
            "state": "DE",
            "postal_code": "199014694",
            "telephone_number": "302-730-4366",
            "fax_number": "302-730-0231"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIMEO",
        "first_name": "FREDERICK",
        "credential": "P.A.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-06",
        "last_updated": "2019-01-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "DE",
            "license": "C50000194",
            "primary": true
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "DE",
            "license": "C50000194",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE NUMBER",
            "identifier": "168809ZA5H",
            "state": "DE"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1000015430",
            "state": "DE"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Dover, DE

Sources for this page

Verify at the official NPI Registry.