Individual provider Active NPI

Deborah Dibble, FNP

  • Family Nurse Practitioner
  • Eden, NY
National Provider Identifier
1952384067
Registry record updated Apr 16, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
F331909 Issued in NY
Practice address
8274 N Main St
Eden, NY 14057-1104
Phone
(716) 575-7282
Fax
(716) 899-5081
NPI assigned
Nov 22, 2005
Last updated
Apr 16, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 16, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X F331909 NY Primary

Addresses

Primary practice location

8274 N Main St
Eden, NY 14057-1104

Mailing address

8274 N Main St
Eden, NY 14057-1104
Phone (716) 575-7282

Other identifiers 1

IdentifierTypeStateIssuer
02576805MedicaidNY

Medicare participation

Medicare enrollment files
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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20031211000305 NY Practitioner - Nurse Practitioner 5597661330 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 1997
Medicare assignment
May accept Medicare assignment
Group practices
Eden Primary CareGroup PAC ID 2860870318, 3 clinicians

Practice addresses (Care Compare)

8274 N Main St
Eden, NY 14057-1104
Phone (716) 725-8114

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
F331909NYMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Eden Primary Care CurrentSince May 1, 2026 Accepting new patients

Locations

8274 N Main St
Eden, NY 14057
Phone (716) 575-7282

Organizations & group practices 1

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.

Hospital & facility affiliations 2

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": "1132617600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1776297600000",
    "number": "1952384067",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8274 N MAIN ST",
            "city": "EDEN",
            "state": "NY",
            "postal_code": "140571104",
            "telephone_number": "716-575-7282",
            "fax_number": "716-899-5081"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8274 N MAIN ST",
            "city": "EDEN",
            "state": "NY",
            "postal_code": "140571104",
            "telephone_number": "716-575-7282",
            "fax_number": "716-899-5081"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIBBLE",
        "first_name": "DEBORAH",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-11-22",
        "last_updated": "2026-04-16",
        "certification_date": "2026-04-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "F331909",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02576805",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Eden, NY

Sources for this page

Verify at the official NPI Registry.