Paul Diegidio, MD

Primary specialty

Plastic and Reconstructive Surgery PhysicianTaxonomy code 2086S0122X

License

201402076 Issued in NC

Practice address

1721 Ebenezer Rd Ste 115
Rock Hill, SC 29732-1119

Phone

(843) 898-8058

Fax

(843) 405-7021

NPI assigned

Jul 6, 2011

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in SC

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1309910400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1588636800000",
    "number": "1780971135",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1721 EBENEZER RD STE 115",
            "city": "ROCK HILL",
            "state": "SC",
            "postal_code": "297321119",
            "telephone_number": "843-898-8058",
            "fax_number": "843-405-7021"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1721 EBENEZER RD STE 115",
            "city": "ROCK HILL",
            "state": "SC",
            "postal_code": "297321119",
            "telephone_number": "843-898-8058",
            "fax_number": "843-405-7021"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "802 Green Valley Rd Ste 108",
            "address_purpose": "LOCATION",
            "city": "Greensboro",
            "state": "NC",
            "postal_code": "274087099",
            "country_code": "US",
            "telephone_number": "843-898-8058",
            "fax_number": "843-405-7021",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "9336 Blakeney Centre Dr Ste 130",
            "address_purpose": "LOCATION",
            "city": "Charlotte",
            "state": "NC",
            "postal_code": "282776667",
            "country_code": "US",
            "telephone_number": "843-898-8058",
            "fax_number": "843-405-7021",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DIEGIDIO",
        "first_name": "PAUL",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-07-06",
        "last_updated": "2020-05-05",
        "certification_date": "2020-05-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086S0122X",
            "taxonomy_group": "",
            "desc": "Surgery, Plastic and Reconstructive Surgery",
            "state": "NC",
            "license": "201402076",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Plastic and Reconstructive Surgery Physician in Rock Hill, SC
• Providers in Rock Hill, SC by specialty
• Plastic and Reconstructive Surgery Physician in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 5, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.