Dr Leonardo Dishman, MD is a medicare enrolled "Pathology - Anatomic Pathology" physician in Malone, New York. His current practice location is
133 Park St, Malone, New York. You can reach out to his office (for appointments etc.) via phone at
(518) 481-6434.
Dr Leonardo Dishman is licensed to practice in New York (license number 160893) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1528176682.
Physician's Profile
| Full Name | Dr Leonardo Dishman |
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| Gender | Male |
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| Speciality | Pathology - Anatomic Pathology |
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| Location | 133 Park St, Malone, New York |
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| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
NPI Data:
- NPI Number: 1528176682
- Provider Enumeration Date: 08/29/2006
- Last Update Date: 03/21/2023
Medicare PECOS Information:
- PECOS PAC ID: 3072557701
- Enrollment ID: I20050614000844
Medical Identifiers
Medical identifiers for Dr Leonardo Dishman such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
| 1528176682 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
| 207ZB0001X | Pathology - Blood Banking & Transfusion Medicine | 160893 (New York) | Secondary |
| 207ZC0500X | Pathology - Cytopathology | 160893 (New York) | Secondary |
| 207ZP0101X | Pathology - Anatomic Pathology | 160893 (New York) | Primary |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Dr Leonardo Dishman allows following entities to bill medicare on his behalf.
| Entity Name | Champlain Valley Physicians Hospital Medical Center |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1124189782 PECOS PAC ID: 2769396878 Enrollment ID: O20031121000623 |
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| Entity Name | Alice Hyde Medical Center |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1114954682 PECOS PAC ID: 4082525837 Enrollment ID: O20031126000357 |
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| Entity Name | Elizabethtown Community Hospital |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1053656744 PECOS PAC ID: 3577554138 Enrollment ID: O20040521000534 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Dr Leonardo Dishman is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
Dr Leonardo Dishman, MD 133 Park St, Malone, NY 12953-1220 Ph: (518) 481-6434 | Dr Leonardo Dishman, MD 133 Park St, Malone, NY 12953-1220 Ph: (518) 481-6434 |
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