Individual provider Active NPI

Desiree Dibella, MD

  • Pediatrics Physician
  • Cincinnati, OH
National Provider Identifier
1730649385
Registry record updated Sep 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
35.149227 Issued in OH
Practice address
3333 Burnet Avenue
ML 6015
Cincinnati, OH 45229-4315
Phone
(513) 636-0800
Fax
(513) 803-0823
NPI assigned
Mar 20, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 23, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 35.149227 OH Primary

Addresses

Primary practice location

3333 Burnet Avenue
ML 6015
Cincinnati, OH 45229-4315

Mailing address

3333 Burnet Avenue
ML 6015
Cincinnati, OH 45229-4315
Phone (513) 636-0800

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
I20240913001235 OH Practitioner - Pediatric Medicine 0648710848 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Children'S Hospital Medical Center Pediatrics CurrentSince Aug 12, 2024 Accepting new patients

Locations

3341 Solutions Ctr
Chicago, IL 60677

3333 Burnet Ave
#6015
Cincinnati, OH 45229
Phone (513) 636-0800

3333 Burnet Ave
#5021
Cincinnati, OH 45229
Phone (513) 636-4225

3333 Burnet Ave
Cincinnati, OH 45229
Phone (513) 636-4200

3333 Burnet Ave
#5018
Cincinnati, OH 45229
Phone (513) 636-4315

2300 Wall St
Ste D
Norwood, OH 45212
Phone (513) 517-3299

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": "1553040000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727049600000",
    "number": "1730649385",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3333 BURNET AVENUE",
            "address_2": "ML 6015",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452294315",
            "telephone_number": "513-636-0800",
            "fax_number": "513-803-0823"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3333 BURNET AVENUE",
            "address_2": "ML 6015",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452294315",
            "telephone_number": "513-636-0800",
            "fax_number": "513-803-0823"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIBELLA",
        "first_name": "DESIREE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-03-20",
        "last_updated": "2024-09-23",
        "certification_date": "2024-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "OH",
            "license": "35.149227",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cincinnati, OH

Sources for this page

Verify at the official NPI Registry.