Active NPI
Robert Joseph Dibenedetto, MD
- Surgery Physician
- Boonton, NJ
National Provider Identifier
1861592586
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgery Physician
- License
- 25MA02906200
- Practice address
- 23 Crestfield Rd
Boonton, NJ 07005-9007 - Phone
- (973) 216-6049
- NPI assigned
- Sep 23, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Obstetrics & Gynecology Physician | 207V00000X | 25MA02906200 | NJ | |
| Surgery Physician | 208600000X | 25MA02906200 | NJ | Primary |
Addresses
Primary practice location
23 Crestfield Rd
Boonton, NJ 07005-9007
Mailing address
23 Crestfield Rd.
Boonton Township, NJ 07005
Phone (973) 216-6049
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 22393 | Other | OK | HEALTHNET |
| PCE155 | Other | OXFORD | |
| 222283772 | Other | HORIZON AETNA CIGNA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 25MA02906200 | NJ | MD | Obstetrics & Gynecology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1158969600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1501027200000",
"number": "1861592586",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "23 CRESTFIELD RD.",
"city": "BOONTON TOWNSHIP",
"state": "NJ",
"postal_code": "07005",
"telephone_number": "973-216-6049"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "23 CRESTFIELD RD",
"city": "BOONTON",
"state": "NJ",
"postal_code": "070059007",
"telephone_number": "973-216-6049"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DIBENEDETTO",
"first_name": "ROBERT",
"middle_name": "JOSEPH",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-09-23",
"last_updated": "2017-07-26",
"status": "A"
},
"taxonomies": [
{
"code": "207V00000X",
"taxonomy_group": "",
"desc": "Obstetrics & Gynecology",
"state": "NJ",
"license": "25MA02906200",
"primary": false
},
{
"code": "208600000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Surgery",
"state": "NJ",
"license": "25MA02906200",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HEALTHNET",
"identifier": "22393",
"state": "OK"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "OXFORD",
"identifier": "PCE155",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HORIZON AETNA CIGNA",
"identifier": "222283772",
"state": null
}
],
"endpoints": [],
"other_names": []
}Other providers in Boonton, NJ
- Developmental Disability Awareness With Love (Ddawl)
- Developmental Disability Awareness With Love (Ddawl)
- Developmental Disability Awareness With Love (Ddawl)
- Developmental Disability Awareness With Love (Ddawl)
- Jonathan Martin Diaz
- Kasey C Divine, CNM
- Lisa Calabrese Dodgen, MA
- Joseph Ryan Donofrio
- Scott Charles Doughty, CADC
- Drug Fair Group, Inc. (Drug Fair of Boonton 54)
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 26, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.