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MARY C DIBENEDETTO PA
NPI 1538113295
Physician Assistant - Medical in Kettering, OH

Active since May 19, 2006PECOS Enrolled
3075 GOVERNORS PLACE BLVD STE 120, KETTERING, OH 45409(937) 424-2580(937) 424-3581 Get Directions Write a Review

NPPES record last updated: November 19, 2018. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Nov 19, 2018, Jan 26, 2017 (2 updates tracked since 2017).

About Mary C Dibenedetto Pa NPPES

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

MARY C DIBENEDETTO PA (NPI 1538113295) is an individual medical provider in Kettering, Ohio, licensed in Georgia (003057) and active in the NPI registry since May 2006. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1538113295
Entity TypeIndividualFemale
Primary Taxonomy363AM0700X
Provider Legal NameMARY C DIBENEDETTOCredential: PA
Location Address3075 GOVERNORS PLACE BLVD STE 120Kettering, OH 45409-1332
Mailing Address3075 Governors Place Blvd, Suite 210Dayton, OH 45409-1332 · (937) 424-8258 · Fax (937) 424-2581
Phone(937) 424-2580
Fax(937) 424-3581
Sole ProprietorNo
Enumeration DateMay 19, 2006
Last NPPES UpdateNovember 19, 20182 updates tracked since enumeration
✔ NPI 1538113295 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician Assistant · MedicalPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363AM0700X
License✔ Licensed in GA · 003057
3075 GOVERNORS PLACE BLVD STE 120, Kettering, OH 45409
Open in Google Maps ↗

Other Identifiers 1

Other1538113295Npi

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Mary C Dibenedetto Pa is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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.

Other Providers at the Same Location NPPES

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

DAYTON ENDOVASCULAR CENTER, LLC
Radiology (Vascular & Interventional Radiology)
3075 GOVERNORS PLACE BLVD STE 120
DAYTON, OH 45409
Montgomery County (513) 773-3455

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Mary Dibenedetto's NPI number?

The NPI number for Mary Dibenedetto is 1538113295. It was assigned to this individual provider in the NPPES registry on May 19, 2006.

Where is Mary Dibenedetto located?

Mary Dibenedetto practices at 3075 Governors Place Blvd Ste 120, Kettering, OH 45409. The listed phone number is (937) 424-2580.

What is Mary Dibenedetto's specialty?

The primary specialty registered for this NPI is Physician Assistant, specializing in Medical, with taxonomy code 363AM0700X.

Is Mary Dibenedetto enrolled in Medicare?

Yes. Mary Dibenedetto is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Mary Dibenedetto was last updated on November 19, 2018. NPI Profile syncs with the weekly NPPES data releases published by CMS.