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DR. TAVENNER TATHEN DIBERT M.D.
NPI 1649627381
Pediatrics - Pediatric Critical Care Medicine in Gainesville, FL

Active since May 23, 2016PECOS EnrolledAccepts Medicare Assignment
1600 SW ARCHER RD, GAINESVILLE, FL 32610(352) 273-9001 Get Directions Write a Review

NPPES record last updated: August 8, 2024. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Dr. Tavenner Tathen Dibert M.d. NPPES

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

DR. TAVENNER TATHEN DIBERT M.D. (NPI 1649627381) is an individual pediatric critical care medicine provider in Gainesville, Florida, licensed in Florida (ME140590) and active in the NPI registry since May 2016. She is enrolled in Medicare PECOS and is a graduate of University Of Florida College Of Medicine (2019).

NPPES Registry Identity

NPI1649627381
Entity TypeIndividualFemale
Primary Taxonomy2080P0203X
Provider Legal NameDR. TAVENNER TATHEN DIBERTCredential: M.D.
Location Address1600 SW ARCHER RDGainesville, FL 32610-3003
Mailing Address1600 Sw Archer RdGainesville, FL 32610-3003 · (352) 273-9001
Phone(352) 273-9001
Sole ProprietorNo
Medical School CMSUniversity Of Florida College Of MedicineGraduated 2019
Enumeration DateMay 23, 2016
Last NPPES UpdateAugust 8, 2024
NPPES CertifiedAugust 8, 2024
✔ NPI 1649627381 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyPediatrics · Pediatric Critical Care MedicineAllopathic & Osteopathic Physicians
Taxonomy Code2080P0203X
License✔ Licensed in FL · ME140590
Definition
A pediatrician expert in advanced life support for children from the term or near-term neonate to the adolescent. This competence extends to the critical care management of life-threatening organ system failure from any cause in both medical and surgical patients and to the support of vital physiological functions. This specialist may have administrative responsibilities for intensive care units and also facilitates patient care among other specialists.
Also ListedPediatricsTaxonomy 208000000X · License ME140590 (FL)
Also ListedPediatrics · Pediatric CardiologyTaxonomy 2080P0202X · License ME140590 (FL)
1600 SW ARCHER RD, Gainesville, FL 32610
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Other Identifiers 1

Medicaid123082700FL

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

Dr. Tavenner Tathen Dibert M.d. 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 ID4587951041
PECOS Enrollment IDI20240919000457
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 20

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

DR. BAHAREH EBADIFAR KEITH DO
Pediatrics
1600 SW ARCHER RD
GAINESVILLE, FL 32610
Alachua County (352) 273-0462
AFRASYAB KHAN
Surgery
1600 SW ARCHER RD
GAINESVILLE, FL 32610
Alachua County (352) 265-0680
GULSUN ERDAG MD
Pathology (Anatomic Pathology & Clinical Pathology)
1600 SW ARCHER RD
GAINESVILLE, FL 32610
Alachua County (352) 265-9900
DR. ALBERT H. MATTIA D.D.S.
Dentist (Prosthodontics)
1600 SW ARCHER RD, D4-4
GAINESVILLE, FL 32610
Alachua County (352) 273-5801
JOANNA CHAFFIN
Pathology (Anatomic Pathology & Clinical Pathology)
1600 SW ARCHER RD
GAINESVILLE, FL 32610
Alachua County (352) 627-9272
DR. CASEY JUSTIN BEAL MD
Ophthalmology
1600 SW ARCHER RD, BOX 100284
GAINESVILLE, FL 32610
Alachua County (352) 273-8778
WILLIAM CRAIG HICKS CRNA
Nurse Anesthetist, Certified Registered
1600 SW ARCHER RD
GAINESVILLE, FL 32610
Alachua County (352) 273-6438
HENRY FONTILLAS PATALINGHUG CRNA
Nurse Anesthetist, Certified Registered
1600 SW ARCHER RD
GAINESVILLE, FL 32610
Alachua County (352) 273-6438

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 Tavenner Dibert's NPI number?

The NPI number for Tavenner Dibert is 1649627381. It was assigned to this individual provider in the NPPES registry on May 23, 2016.

Where is Tavenner Dibert located?

Tavenner Dibert practices at 1600 SW Archer Rd, Gainesville, FL 32610. The listed phone number is (352) 273-9001.

What is Tavenner Dibert's specialty?

The primary specialty registered for this NPI is Pediatrics, specializing in Pediatric Critical Care Medicine, with taxonomy code 2080P0203X.

Is Tavenner Dibert enrolled in Medicare?

Yes. Tavenner Dibert is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

When was this NPI record last updated?

The NPPES record for Tavenner Dibert was last updated on August 8, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.