Jeremy Daniel Dibiasio, is a medicare enrolled "Student In An Organized Health Care Education/training Program" in Warwick, Rhode Island. He graduated from nursing school in 2020 and has 4 years of diverse experience with area of expertise as Nurse Practitioner. He is a member of the group practice Lifespan Physician Group Inc and his current practice location is
17 Airport Rd, Warwick, Rhode Island. You can reach out to his office (for appointments etc.) via phone at
(401) 606-2520.
Jeremy Daniel Dibiasio is licensed to practice in * (Not Available) (license number ) 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 1114533783.
Provider's Profile
| Full Name | Jeremy Daniel Dibiasio |
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| Gender | Male |
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| Speciality | Nurse Practitioner |
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| Experience | 4 Years |
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| Location | 17 Airport Rd, Warwick, Rhode Island |
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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:
- Jeremy Daniel Dibiasio graduated from nursing school in 2020
NPI Data:
- NPI Number: 1114533783
- Provider Enumeration Date: 09/19/2020
- Last Update Date: 09/09/2021
Medicare PECOS Information:
- PECOS PAC ID: 9739578097
- Enrollment ID: I20211109000256
Medical Identifiers
Medical identifiers for Jeremy Daniel Dibiasio such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1114533783 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 363LF0000X | Nurse Practitioner - Family | APRN02742 (Rhode Island) | Secondary |
| 390200000X | Student In An Organized Health Care Education/training Program | (* (Not Available)) | Primary |
Medical Facilities Affiliation
Group Practice Association
| Group Practice Name | Group PECOS PAC ID | No. of Members |
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| Lifespan Physician Group Inc | 2567455082 | 634 |
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. Jeremy Daniel Dibiasio allows following entities to bill medicare on his behalf.
| Entity Name | Lifespan Physician Group Inc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1285191163
PECOS PAC ID: 2567455082
Enrollment ID: O20190603001535 |
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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. Jeremy Daniel Dibiasio 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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Jeremy Daniel Dibiasio,
17 Airport Rd,
Warwick, RI 02889-1001
Ph: (401) 606-2520 | Jeremy Daniel Dibiasio,
17 Airport Rd,
Warwick, RI 02889-1001
Ph: (401) 606-2520 |
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