MICHAEL R DIBENEDETTO MD PLLC (NPI# 1083809727) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1083809727 |
| Entity Type | Organization |
| Organization Name | MICHAEL R DIBENEDETTO MD PLLC |
| Other Organization Name | NORTH IDAHO ORTHOPEDICS & SPORTS MEDICINE |
| Practice Address |
30544 Hwy 200 Ste 102 Ponderay ID 83852 |
| Practice Telephone | 2082659836 |
| Practice Fax Number | 2082659839 |
| Mailing Telephone | 2082659836 |
| Mailing Fax Number | 2082659839 |
| Enumeration Date | 2007-09-06 |
| Last Update Date | 2013-04-09 |
| Authorized Official Name | MRS. KATIE R FISHER (PRACTICE MANAGER) |
| Authorized Official Telephone | 2082656700 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207X00000X | Orthopaedic Surgery | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| ID | BLUE CROSS | 8N259 | 01 |
| ID | 806452000 | 05 | |
| ID | PALMETTO GBA RAILROAD MED | DG3627 | 01 |
| ID | REGENCE BLUE SHIELD | 000010140056 | 01 |
| Other Name | Type Code |
|---|---|
| North Idaho Orthopedics & Sports Medicine | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073757464 | Michael R Dibenedetto Md Pllc | Surgery | 30544 Highway 200, Suite 102, Ponderay, ID 83852-5005 | 2009-04-29 |
| Street Address |
30544 HWY 200 STE 102 |
| City | PONDERAY |
| State | ID |
| Zip Code | 83852 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346606647 | Vern Stairs | Pharmacist | 476999 Us-95, Walmart Supercenter, Ponderay, ID 83852 | 2016-01-04 |
| 1811009988 | David Paul Cox | Dentist | 477542 Hwy 95 N, Ponderay, ID 83852 | 2006-08-31 |
| 1861774291 | Michael David Schicker | Orthopaedic Surgery | 30544 Highway 200 Ste 102, Ponderay, ID 83852 | 2011-09-12 |
| 1750410825 | Glacier Prosthetic Care, Inc. | Prosthetic/Orthotic Supplier | 205 Vermeer Dr, Suite C, Ponderay, ID 83852-1660 | 2007-03-05 |
| 1083949531 | Mario E Roxas | Naturopath | 476864 Highway 95, Suite #3, Ponderay, ID 83852-5000 | 2009-10-15 |
| 1942716246 | Darwin L Hurst | Family Medicine | 30544 Highway 200 Ste 101, Ponderay, ID 83852-5005 | 2017-12-21 |
| 1902036734 | Innovative Anesthesia | Nurse Anesthetist, Certified Registered | 30544 Highway 200 Ste 201, Pend Oreille Surgery Center, Ponderay, ID 83852-5005 | 2009-07-14 |
| 1255597811 | Travis Lee Taylor | Nurse Practitioner | 30544 Highway 200 Ste 102, Ponderay, ID 83852-5005 | 2008-08-04 |
| 1982741195 | Ryan Leisy | Chiropractor | 30544 Highway 200 Ste 330, Ponderay, ID 83852-5005 | 2007-01-30 |
| 1780651539 | Bruce William Demko | Nurse Anesthetist, Certified Registered | 30544 Highway 200, Ponderay, ID 83852-5005 | 2006-03-01 |
| Find all providers in zip 83852 | ||||
| Taxonomy Code | 207X00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Orthopaedic Surgery |
| An orthopaedic surgeon is trained in the preservation, investigation and restoration of the form and function of the extremities, spine and associated structures by medical, surgical and physical means. An orthopaedic surgeon is involved with the care of patients whose musculoskeletal problems include congenital deformities, trauma, infections, tumors, metabolic disturbances of the musculoskeletal system, deformities, injuries and degenerative diseases of the spine, hands, feet, knee, hip, shoulder and elbow in children and adults. An orthopaedic surgeon is also concerned with primary and secondary muscular problems and the effects of central or peripheral nervous system lesions of the musculoskeletal system. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Orthopaedic Surgery, 2007. http://www.abos.org/. American Osteopathic Board of Orthopaedic Surgery, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Orthopaedic Surgery. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Orthopaedic Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679644397 | Michael Raymond Dibenedetto | Orthopaedic Surgery | 30544 Highway 200, Ste 102, Ponderay, ID 83852-5005 | 2006-11-13 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770101594 | Brittney Davis | Orthopaedic Surgery | 5910 W Targee St, Boise, ID 83709-3151 | 2020-07-08 |
| 1992208631 | Orthopedic Surgery and Sports | Orthopaedic Surgery | 1812 N Lakewood Drive, Suite 100, Coeur D'alene, ID 83814 | 2018-03-08 |
| 1942668157 | Allied Orthopaedics, LLC | Orthopaedic Surgery | 1789 S Broadway Ave, Suite 100, Boise, ID 83706-3800 | 2016-02-02 |
| 1053779264 | Allied Orthopaedics, LLC | Orthopaedic Surgery | 16818 N Marketplace Blvd, Nampa, ID 83687-5140 | 2016-02-02 |
| 1841611027 | Christopher Frederic Jessen | Orthopaedic Surgery | 5475 E Shoreline Dr, Post Falls, ID 83854-6858 | 2013-12-14 |
| 1881934404 | Kym Orthopedics Pllc | Orthopaedic Surgery | 3316 4th St #4b, Lewiston, ID 83501-4405 | 2013-02-19 |
| 1891056826 | Jonathan Klaucke | Orthopaedic Surgery | 606 N Third Ave Ste 201, Sandpoint, ID 83864 | 2012-06-06 |
| 1508168139 | Lyman Orthopedics Pllc | Orthopaedic Surgery | 1875 N Lakewood Dr, Suite 200, Coeur D Alene, ID 83814-4928 | 2010-12-02 |
| 1639495708 | Krysten Marie Bell | Orthopaedic Surgery | 2178 S Myers Pl, Boise, ID 83706-5503 | 2010-04-14 |
| 1700114725 | David Louis Schenkar | Orthopaedic Surgery | 110 E Gulch Rd, Hailey, ID 83333-8496 | 2009-12-02 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.