Michael R Dibenedetto MD PLLC
NPI 1073757464ActiveOrganization· Surgery, Plastic and Reconstructive Surgery· Ponderay, ID
Surgery, Plastic and Reconstructive Surgery in Ponderay, Idaho, registered in NPPES in April 2009, part of Michael R Dibenedetto MD PLLC. The authorized official on file is Wendy S. Brosnahan, Office Manager.
Overview
| NPI | 1073757464 |
|---|---|
| Status | Active |
| Entity type | Organization (subpart) |
| Parent organization | Michael R Dibenedetto MD PLLC |
| NPI issued | Apr 29, 2009 |
| Last updated in NPPES | Oct 21, 2009 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Surgery, Plastic and Reconstructive Surgery Primary | 2086S0122X | M10671 | ID |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Not in the public enrollment file of Oct 1, 2026 |
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