Joseph John Dipeso, D.C.
Individual provider Active NPI Chiropractor · Fallston, MD
NPI 1679697494 · NPPES record last updated Oct 11, 2011
Key facts
- NPI
- 1679697494
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Chiropractor 111N00000X
- License
- 01797 (MD)
- Practice address
- 2404 Pleasantville Road
Suite 6
Fallston, MD 21047-2099 - Phone
- (410) 803-8480
- Fax
- (410) 803-4840
- NPI assigned
- Mar 19, 2007
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 1
Medicare Care Compare profile
- Specialty
- Chiropractic
- Education
- New York Chiropractic College, 1996
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
2404 Pleasantville Rd
Suite 6
Fallston, MD 21047-2099
Phone (410) 803-8480
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MD
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20120416000550 | MD | Practitioner - Chiropractic | 1850552068 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 01797 | MD | MD | Podiatrist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Dipeso Chiropractic Center | Current |
Accepting new patients |
Locations
2404 Pleasantville Rd
Ste 6
Fallston, MD 21047
Phone (410) 803-8480
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 01797 | MD | Yes |
Addresses
Primary practice location
2404 Pleasantville Road
Suite 6
Fallston, MD 21047-2099
Mailing address
2404 Pleasantville Road
Suite 6
Fallston, MD 21047-2099
Phone (410) 803-8480
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| T421-0001 | Other | MD | BCBS (FEP & GHMSI) |
| M452 | Other | MD | BCBS (MD) |
Other providers in Fallston, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 11, 2011. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.