JACLYN MARY DIBELLO
NPI 1154061638
Emergency Medicine in Staten Island, NY

Q: What is Jaclyn Dibello's NPI number?

The NPI number for Jaclyn Dibello is 1154061638. It was assigned to this individual provider in the NPPES registry on March 31, 2022.

Q: What is Jaclyn Dibello's specialty?

The primary specialty registered for this NPI is Emergency Medicine with taxonomy code 207P00000X.

Q: When was this NPI record last updated?

The NPPES record for Jaclyn Dibello was last updated on August 27, 2025. NPI Profile syncs with the weekly NPPES data releases published by CMS.

Active since March 31, 2022PECOS EnrolledAccepts Medicare Assignment

475 SEAVIEW AVE, STATEN ISLAND, NY 10305(718) 226-1548(718) 226-8447 Get Directions Write a Review

NPPES record last updated: August 27, 2025. Verified against the NPPES registry weekly; last sync: July 26, 2026.

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About Jaclyn Mary Dibello NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

JACLYN MARY DIBELLO (NPI 1154061638) is an individual emergency medicine provider in Staten Island, New York, licensed in New York (335570-01) and active in the NPI registry since March 2022. She is enrolled in Medicare PECOS, is affiliated with Staten Island University Hospital, and is a graduate of State University Of New York At Stony Brook, School Of Medicine (2022).

NPPES Registry Identity

NPI1154061638

Entity TypeIndividualFemale

Primary Taxonomy207P00000X

Provider Legal NameJACLYN MARY DIBELLO

Location Address475 SEAVIEW AVEStaten Island, NY 10305-3436

Mailing Address475 Seaview AveStaten Island, NY 10305-3436 · (718) 226-1548 · Fax (718) 226-8447

Phone(718) 226-1548

Fax(718) 226-8447

Sole ProprietorNo

Medical School CMSState University Of New York At Stony Brook, School Of MedicineGraduated 2022

Enumeration DateMarch 31, 2022

Last NPPES UpdateAugust 27, 2025

NPPES CertifiedAugust 27, 2025

✔ NPI 1154061638 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyEmergency MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207P00000X

License✔ Licensed in NY · 335570-01

Definition

An emergency physician focuses on the immediate decision making and action necessary to prevent death or any further disability both in the pre-hospital setting by directing emergency medical technicians and in the emergency department. The emergency physician provides immediate recognition, evaluation, care, stabilization and disposition of a generally diversified population of adult and pediatric patients in response to acute illness and injury.

475 SEAVIEW AVE, Staten Island, NY 10305

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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Jaclyn Mary Dibello is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID9931622859

PECOS Enrollment IDI20250401000981

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Hospital Affiliations CMS Care Compare

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Staten Island University Hospital

Acute Care Hospitals · Staten Island, NY

1/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number330160

Location475 Seaview AvenueStaten Island, NY 10305 · Richmond County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 10305 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$105.06 typical visit price

range $67.40 – $203.53

Typical copayment $26.26 (range $16.85 – $50.88)

Most-billed visit code 99203

Established Patient

$117.62 typical visit price

range $21.66 – $164.45

Typical copayment $29.40 (range $5.41 – $41.11)

Most-billed visit code 99214

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

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Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MRS. DAWN MARIE COTTONE RPA-C

Physician Assistant (Surgical)