Mary Jo Dimilia, M.D.

Primary specialty

Adolescent Medicine (Internal Medicine) PhysicianTaxonomy code 207RA0000X

License

197284-1 Issued in NY

Practice address

1150 Park Ave
New York, NY 10128-1244

Phone

(347) 746-2144

NPI assigned

Sep 9, 2007

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in NY

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

Practice roles

Locations

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.

• Icahn School of Medicine at Mount Sinai

  dba FPA Urgent Care Center

  • Emergency Medicine Physician
  • New York, NY
  • NPI 1124392238
  Medicare reassignment NPD

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

{
    "created_epoch": "1189296000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1394150400000",
    "number": "1871788273",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1150 PARK AVE",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "101281244",
            "telephone_number": "212-348-1454"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1150 PARK AVE",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "101281244",
            "telephone_number": "347-746-2144"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIMILIA",
        "first_name": "MARY JO",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-09-09",
        "last_updated": "2014-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RA0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Adolescent Medicine",
            "state": "NY",
            "license": "197284-1",
            "primary": true
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NY",
            "license": "197284",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Christopher A Dimeo, MD
• Rosemary Dimicelli, DENTAL HYGIENIST
• Alexandra B Dimich, MD
• Ivan G Dimich, M.D.
• Donna Dimichele, MD
• Samantha Elizabeth Dimisa, PH.D.
• Elisabeth Dimitratos, PA
• Diana Maria Dimitri, PH.D.
• Nadya E Dimitrov, DPM
• Kamellia Rangelova Dimitrova, M.D.

• Adolescent Medicine (Internal Medicine) Physician in New York, NY
• Providers in New York, NY by specialty
• Adolescent Medicine (Internal Medicine) Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2014; 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.