Gregory Alan Dicamillo, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

MD61181093 Issued in WA

Practice address

418 W Main
Brewster, WA 98813

Phone

(509) 663-8711

NPI assigned

Apr 23, 2017

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in TX, WA, MP3 enrollments

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 3

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

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.

• Commonwealth Healthcare Corporation

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Saipan, MP
  • NPI 1285858290

  MP

  Medicare reassignment Care Compare group NPD
• Chelan County Public Hospital District No 2

  • Critical Access Hospital
  • Chelan, WA
  • NPI 1578568853

  WA

  Medicare reassignment NPD
• Northwest Emergency Physicians LLC

  • Emergency Medicine Physician
  • Arlington, WA
  • NPI 1235172370

  Emergency Medicine, WA

  Medicare reassignment NPD
• Okanogan County Public Hospital Dist No 4

  • Critical Access Hospital
  • Tonasket, WA
  • NPI 1164580700

  WA

  Medicare reassignment NPD
• Okanogan County Public Hospital Dist No 4

  • Medical Specialty Clinic/Center
  • Tonasket, WA
  • NPI 1750443834

  WA

  Medicare reassignment NPD
• Okanogan Douglas County Hospital Dist 1

  • Critical Access Hospital
  • Brewster, WA
  • NPI 1356305395

  WA

  Medicare reassignment NPD
• Wenatchee Valley Hospital

  • Multi-Specialty Clinic/Center
  • Wenatchee, WA
  • NPI 1669719688

  WA

  Medicare reassignment NPD
• Basin Emergency Physicians PLLC

  • Emergency Medicine Physician
  • Odessa, TX
  • NPI 1831337724

  Emergency Medicine, TX

  Medicare reassignment NPD
• Nurocoach Medical Group PLLC

  • Psychiatry Physician
  • Sugar Land, TX
  • NPI 1083332845

  TX

  Medicare reassignment NPD
• Commonwealth Healthcare Corporation

  • General Acute Care Hospital
  • Saipan, MP
  • NPI 1871616292
  Care Compare group NPD
• Chelan County Public Hospital Dist No 2

  • Critical Access Hospital
  • Chelan, WA
  • NPI 1831358696
  NPD
• Chelan County Public Hospital District No 2

  • Rural Health Clinic/Center
  • Chelan, WA
  • NPI 1124438312
  NPD

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

• Commonwealth Healthcare Corporation

  • General Acute Care Hospital
  • Saipan, MP
  • NPI 1871616292

  Hospital

  Care Compare affiliation

Specialty

Emergency Medicine

Education

Baylor College of Medicine, 2013

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Commonwealth Healthcare Corporation 79 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Commonwealth Health Center Hospital, Garapan, MP, CCN 660001

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

{
    "created_epoch": "1492905600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1630454400000",
    "number": "1669907077",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "820 N CHELAN AVE",
            "city": "WENATCHEE",
            "state": "WA",
            "postal_code": "988012028",
            "telephone_number": "509-663-8711"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "418 W MAIN",
            "city": "BREWSTER",
            "state": "WA",
            "postal_code": "98813",
            "telephone_number": "509-663-8711"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "203 S Western Ave",
            "address_purpose": "LOCATION",
            "city": "Tonasket",
            "state": "WA",
            "postal_code": "988558803",
            "country_code": "US",
            "telephone_number": "509-486-2151",
            "fax_number": "509-486-3176",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DICAMILLO",
        "first_name": "GREGORY",
        "middle_name": "ALAN",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-04-23",
        "last_updated": "2021-09-01",
        "certification_date": "2021-09-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "WA",
            "license": "MD61181093",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WA",
            "license": "MD61181093",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicproxy.et0764.epichosted.com/FHIRProxy/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "418 W MAIN",
            "city": "BREWSTER",
            "state": "WA",
            "country_code": "US",
            "postal_code": "98813",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Tyler Ryan Copenhaver, D.C.
• Tad Leon Davis, MD
• Nicole Brooke Demarco, OD
• Belinda Clare Denchfield, CMSRN
• Victoria Malloch Desalvo, ARNP
• Gwendolyn Dick, L.M.P.
• Douglas Okanogan County Fire District 15
• Mary Downey, PA-C
• Dr Duane L Rana P S
• Elias Driessen, DPT

• All providers in Brewster, WA
• Family Medicine Physician in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 1, 2021; 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.