Individual provider Active NPI

Joseph Dimino, MSPT

  • Physical Therapist
  • Staten Island, NY
National Provider Identifier
1780896654
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
017624-1 Issued in NY
Practice address
299 Guyon Ave
Staten Island, NY 10306-4134
Phone
(718) 667-7700
Fax
(718) 677-7710
NPI assigned
May 4, 2007
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 017624-1 NY Primary

Addresses

Primary practice location

299 Guyon Ave
Staten Island, NY 10306-4134

Mailing address

420 Guyon Ave
Staten Island, NY 10306-5521
Phone (718) 667-7700

Other identifiers 5

IdentifierTypeStateIssuer
0007963400OtherNYAETNA
184064OtherNYELDERPLAN
QA 5703OtherNYBLUE CROSS BLUE SHIELD
P2055450OtherNYOXFORD
294096POtherNYHIP

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040505001590 NY Practitioner - Physical Therapist in Private Practice 7517955685 Practice locations: Staten Island, NY

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

299 Guyon Ave
Staten Island, NY 10306-4134
Phone (718) 667-7700

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
017624-1NYMDPediatric Occupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Darwish Wellness Medical Office PC PastSince Feb 4, 2024 Accepting new patients
Marraccini & Crispino Podiatric LLP Past Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1178236800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1780896654",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "420 GUYON AVE",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103065521",
            "telephone_number": "718-667-7700",
            "fax_number": "718-667-7710"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "299 GUYON AVE",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103064134",
            "telephone_number": "718-667-7700",
            "fax_number": "718-677-7710"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIMINO",
        "first_name": "JOSEPH",
        "name_prefix": "Mr.",
        "credential": "MSPT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-05-04",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "017624-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "0007963400",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ELDERPLAN",
            "identifier": "184064",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "QA 5703",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OXFORD",
            "identifier": "P2055450",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HIP",
            "identifier": "294096P",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Staten Island, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.