Individual provider Active NPI

Jared Dibenedetto

  • Emergency Medicine Physician
  • Worcester, MA
National Provider Identifier
1932554292
Registry record updated May 24, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
278137 Issued in MA
Practice address
55 Lake Ave N
Upmc Presbyterian Hospital
Worcester, MA 01655-0002
Phone
(508) 421-1400
NPI assigned
Apr 24, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 24, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 278137 MA Primary

Addresses

Primary practice location

55 Lake Ave N
Upmc Presbyterian Hospital
Worcester, MA 01655-0002

Mailing address

PO Box 415348
Upmc Presbyterian Hospital
Boston, MA 02241-5348

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address upmchospitals@upmcdirect.com UPMC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA, OR2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20200615001216 PA Practitioner - Emergency Medicine 1254678741 Reassigns benefits to 1 organization
I20240611001249 OR Practitioner - Emergency Medicine 1254678741 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Albany Medical College of Union University, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Providence Health and Services - OregonGroup PAC ID 9335057447, 212 clinicians

Practice addresses (Care Compare)

9205 SW Barnes Rd
Portland, OR 97225-6603
Phone (503) 216-2213

Hospital & facility affiliations

  • Providence St Vincent Medical Center Hospital, Portland, OR, CCN 380004

Merit-based Incentive Payment System (MIPS)

Final score
80.94 of 100Reported as group
Quality
61.89
Promoting interoperability
100
Improvement activities
40
Cost
74.58

Merit-based Incentive Payment System (MIPS)

Final score
95.65 of 100Reported as group
Quality
98.12
Promoting interoperability
100
Improvement activities
40
Cost
80.38

Procedures performed for Medicare patients

ProcedureNumber of procedures
Upper gastrointestinal (GI) endoscopy for acid reflux1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
University of Pittsburgh Physicians Emergency Medicine CurrentSince Jun 1, 2020 Accepting new patients
University of Pittsburgh Physicians CurrentSince Jun 1, 2020 Accepting new patients
University of Pittsburgh Physicians Current Accepting new patients
Providence Health & Services - Oregon Emergency Medicine CurrentSince Jun 1, 2024 Accepting new patients
Providence Health & Services - Oregon Emergency Medicine CurrentSince Jun 1, 2024 Accepting new patients

Locations

9205 SW Barnes Rd
Portland, OR 97225
Phone (503) 216-1234

2 Hot Metal St
#One
Pittsburgh, PA 15203
Phone (412) 432-5864

200 Lothrop St
Pittsburgh, PA 15213
Phone (412) 647-3553

Organizations & group practices 5

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1461456000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1621814400000",
    "number": "1932554292",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 415348",
            "address_2": "UPMC PRESBYTERIAN HOSPITAL",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "022415348"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "55 LAKE AVE N",
            "address_2": "UPMC PRESBYTERIAN HOSPITAL",
            "city": "WORCESTER",
            "state": "MA",
            "postal_code": "016550002",
            "telephone_number": "508-421-1400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIBENEDETTO",
        "first_name": "JARED",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-04-24",
        "last_updated": "2021-05-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "MA",
            "license": "278137",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "upmchospitals@upmcdirect.com",
            "affiliation": "Y",
            "affiliationName": "UPMC",
            "address_1": "600 Grant St",
            "address_2": "Floor 58",
            "city": "Pittsburgh",
            "state": "PA",
            "country_code": "US",
            "postal_code": "152192702",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Worcester, MA

Sources for this page

Verify at the official NPI Registry.