Individual provider Active NPI

John W Difiore, MD

  • Pediatric Surgery Physician
  • Charlotte, NC
National Provider Identifier
1700840469
Registry record updated Jun 20, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Surgery PhysicianTaxonomy code 2086S0120X
License
2014-00192 Issued in NC
Practice address
1025 Morehead Medical Dr
Suite 275
Charlotte, NC 28204-2963
Phone
(704) 403-2662
Fax
(704) 403-2670
NPI assigned
Apr 12, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 20, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Surgery Physician 2086S0120X 35075425D OH
Pediatric Surgery Physician 2086S0120X 2014-00192 NC Primary

Addresses

Primary practice location

1025 Morehead Medical Dr
Suite 275
Charlotte, NC 28204-2963

Mailing address

PO Box 601888
Charlotte, NC 28260-1888
Phone (704) 403-2662

Other identifiers 3

IdentifierTypeStateIssuer
1700840469MedicaidNC
2082370MedicaidOH
NC2063MedicaidSC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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 1

Enrollment IDStateProvider typePAC IDDetails
I20131015001183 OH Practitioner - General SurgeryPractitioner - Other (Physician) 7012957525 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
Columbia University College of Physicians and Surgeons, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cleveland ClinicGroup PAC ID 1850203555, 6,954 clinicians

Practice addresses (Care Compare)

9500 Euclid Ave
Cleveland, OH 44195-0001
Phone (216) 738-5014

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
2014-00192NCMDPediatric Surgery Physician
35075425DOHMDPediatric Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
The Cleveland Clinic Foundation CurrentSince Aug 28, 2013 Accepting new patients

Locations

2500 Metrohealth Dr
Cleveland, OH 44109
Phone (216) 778-2348

9500 Euclid Ave
Cleveland, OH 44195
Phone (216) 442-1270

9500 Euclid Ave
#L22
Cleveland, OH 44195
Phone (216) 738-5014

6801 Mayfield Rd
Ste 200
Mayfield Heights, OH 44124
Phone (440) 312-4981

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1144800000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1403222400000",
    "number": "1700840469",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 601888",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282601888",
            "telephone_number": "704-403-2662",
            "fax_number": "704-403-2670"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1025 MOREHEAD MEDICAL DR",
            "address_2": "SUITE 275",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282042963",
            "telephone_number": "704-403-2662",
            "fax_number": "704-403-2670"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIFIORE",
        "first_name": "JOHN",
        "middle_name": "W",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-12",
        "last_updated": "2014-06-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086S0120X",
            "taxonomy_group": "",
            "desc": "Surgery, Pediatric Surgery",
            "state": "OH",
            "license": "35075425D",
            "primary": false
        },
        {
            "code": "2086S0120X",
            "taxonomy_group": "",
            "desc": "Surgery, Pediatric Surgery",
            "state": "NC",
            "license": "2014-00192",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1700840469",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2082370",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "NC2063",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Charlotte, NC

Sources for this page

Verify at the official NPI Registry.