Michael Raymond Dibenedetto, MD is a medicare enrolled "Orthopaedic Surgery" physician in Ponderay, Idaho. He went to Ohio State University College Of Medicine and graduated in 1985 and has 39 years of diverse experience with area of expertise as Orthopedic Surgery. He is a member of the group practice Boundary Community Hospital, Michael R Dibenedetto Md Pllc and his current practice location is
30544 Highway 200, Ste 102, Ponderay, Idaho. You can reach out to his office (for appointments etc.) via phone at
(208) 265-9817.
Michael Raymond Dibenedetto is licensed to practice in Idaho (license number M8578) and he also participates in the medicare program. He
accepts medicare assignments (which means he accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and his NPI Number is 1679644397.
Physician's Profile
| Full Name | Michael Raymond Dibenedetto |
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| Gender | Male |
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| Speciality | Orthopedic Surgery |
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| Experience | 39 Years |
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| Location | 30544 Highway 200, Ponderay, Idaho |
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| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
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Medical Education and Training:
- Michael Raymond Dibenedetto attended and graduated from Ohio State University College Of Medicine in 1985
NPI Data:
- NPI Number: 1679644397
- Provider Enumeration Date: 11/13/2006
- Last Update Date: 04/03/2013
Medicare PECOS Information:
- PECOS PAC ID: 7113819525
- Enrollment ID: I20040329001019
Medical Identifiers
Medical identifiers for Michael Raymond Dibenedetto such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1679644397 | NPI | - | NPPES |
| 77010 | Other | ID | BLUE CROSS |
| 806452000 | Medicaid | ID | |
| P00042698 | Other | ID | PALMETTOGBA RAILROAD MEDI |
| 000010140056 | Other | ID | REGENCE |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 207X00000X | Orthopaedic Surgery | M8578 (Idaho) | Primary |
Medical Facilities Affiliation
Group Practice Association
| Group Practice Name | Group PECOS PAC ID | No. of Members |
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| Boundary Community Hospital | 3274583406 | 21 |
| Michael R Dibenedetto Md Pllc | 0840385670 | 7 |
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. Michael Raymond Dibenedetto allows following entities to bill medicare on his behalf.
| Entity Name | Boundary Community Hospital |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1801896683
PECOS PAC ID: 3274583406
Enrollment ID: O20050126000312 |
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| Entity Name | Michael R Dibenedetto Md Pllc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1083809727
PECOS PAC ID: 0840385670
Enrollment ID: O20071009000187 |
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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. Michael Raymond Dibenedetto 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 |
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Michael Raymond Dibenedetto, MD
30544 Highway 200, Ste 102,
Ponderay, ID 83852-5005
Ph: (208) 265-9817 | Michael Raymond Dibenedetto, MD
30544 Highway 200, Ste 102,
Ponderay, ID 83852-5005
Ph: (208) 265-9817 |
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