NPIMap

Organization Active NPI

Mary Ann Dibiagio DO PC

  • Non-Pharmacy Dispensing Site
  • Ellwood City, PA
National Provider Identifier
1710028832
Registry record updated Mar 3, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Non-Pharmacy Dispensing SiteTaxonomy code 332900000X
License
OS005303L Issued in PA
Legal business name
MARY ANN DIBIAGIO DO PC
Doing business as
Mary Ann DiBiagio DO
Practice address
1673 State Route 65
Ellwood City, PA 16117
Phone
(724) 758-7559
NPI assigned
Feb 9, 2007
Organization subpart
Yes
Parent organization
MEDVANTX, INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Mar 3, 2015

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

Authorized official

Name
Kenny Heine
Title
VP of Operations
Phone
(858) 625-2990

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Non-Pharmacy Dispensing Site 332900000X OS005303L PA Primary

Addresses

Primary practice location

1673 State Route 65
Ellwood City, PA 16117

Mailing address

5626 Oberlin Dr
Suite 110
San Diego, CA 92121-1705

Other names 1

  • Mary Ann DiBiagio DO Doing business as

National Provider Directory

National Provider Directory
Part of
Tri - State Medical Group Inc

NPI Registry JSON

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

{
    "created_epoch": "1170979200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1425340800000",
    "number": "1710028832",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5626 OBERLIN DR",
            "address_2": "SUITE 110",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921211705"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1673 STATE ROUTE 65",
            "city": "ELLWOOD CITY",
            "state": "PA",
            "postal_code": "16117",
            "telephone_number": "724-758-7559"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARY ANN DIBIAGIO DO PC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MEDVANTX, INC",
        "enumeration_date": "2007-02-09",
        "last_updated": "2015-03-03",
        "status": "A",
        "authorized_official_last_name": "HEINE",
        "authorized_official_first_name": "KENNY",
        "authorized_official_title_or_position": "VP OF OPERATIONS",
        "authorized_official_telephone_number": "858-625-2990"
    },
    "taxonomies": [
        {
            "code": "332900000X",
            "taxonomy_group": "",
            "desc": "Non-Pharmacy Dispensing Site",
            "state": "PA",
            "license": "OS005303L",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Mary Ann DiBiagio DO",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Ellwood City, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 3, 2015; 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.