MICHAEL RAYMOND DIBENEDETTO M.D.
NPI 1679644397
Orthopaedic Surgery in Ponderay, ID

Q: What is Michael Dibenedetto's NPI number?

The NPI number for Michael Dibenedetto is 1679644397. It was assigned to this individual provider in the NPPES registry on November 13, 2006.

Q: What is Michael Dibenedetto's specialty?

The primary specialty registered for this NPI is Orthopaedic Surgery with taxonomy code 207X00000X.

Active since November 13, 2006PECOS EnrolledAccepts Medicare Assignment

0/100

CMS Quality Rating

30544 HIGHWAY 200, STE 102, PONDERAY, ID 83852(208) 265-9817(208) 265-4533 Get Directions Write a Review

NPPES record last updated: April 3, 2013. Verified against the NPPES registry weekly; last sync: August 02, 2026.

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About Michael Raymond Dibenedetto M.d. NPPES

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

MICHAEL RAYMOND DIBENEDETTO M.D. (NPI 1679644397) is an individual orthopaedic surgery provider in Ponderay, Idaho, licensed in Idaho (M8578) and active in the NPI registry since November 2006. He is enrolled in Medicare PECOS, is affiliated with Kootenai Health, and is a graduate of Ohio State University College Of Medicine (1985).

NPPES Registry Identity

NPI1679644397

Entity TypeIndividualMale

Primary Taxonomy207X00000X

Provider Legal NameMICHAEL RAYMOND DIBENEDETTOCredential: M.D.

Location Address30544 HIGHWAY 200, STE 102Ponderay, ID 83852-5005

Mailing Address30544 Highway 200, Ste 102Ponderay, ID 83852-5005 · (208) 265-9817 · Fax (208) 265-4533

Phone(208) 265-9817

Fax(208) 265-4533

Sole ProprietorNo

Medical School CMSOhio State University College Of MedicineGraduated 1985

Enumeration DateNovember 13, 2006

Last NPPES UpdateApril 3, 2013

✔ NPI 1679644397 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyOrthopaedic SurgeryAllopathic & Osteopathic Physicians

Taxonomy Code207X00000X

License✔ Licensed in ID · M8578

Definition

An orthopaedic surgeon is trained in the preservation, investigation and restoration of the form and function of the extremities, spine and associated structures by medical, surgical and physical means. An orthopaedic surgeon is involved with the care of patients whose musculoskeletal problems include congenital deformities, trauma, infections, tumors, metabolic disturbances of the musculoskeletal system, deformities, injuries and degenerative diseases of the spine, hands, feet, knee, hip, shoulder and elbow in children and adults. An orthopaedic surgeon is also concerned with primary and secondary muscular problems and the effects of central or peripheral nervous system lesions of the musculoskeletal system.

30544 HIGHWAY 200, Ponderay, ID 83852

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Other Identifiers 7

OtherP00042698ID · Palmettogba Railroad Medi

Medicaid806452000ID

Medicare UPINF77409

Other000010140056ID · Regence

Medicare NSC5302280001ID

Medicare PIN11066821ID

Other77010ID · Blue Cross

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include PacificSource Health Plans, Providence Health Plan.Insurance ›

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

Michael Raymond Dibenedetto 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 ID7113819525

PECOS Enrollment IDI20040329001019

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.

Areas of Expertise CMS Part B claims 18

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214

This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.

234 services167 patients

Injection, betamethasone acetate 3 mg and betamethasone sodium phosphate 3 mg J0702

This injection contains two medications, betamethasone acetate and betamethasone sodium phosphate. It is used to reduce inflammation and pain. It's given by a healthcare professional, often directly into the area causing discomfort.

119 services83 patients

New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more 99204

This is a first-time office or outpatient visit lasting between 45-59 minutes. The healthcare provider evaluates your health, discusses your medical history, and may suggest further tests or treatments. It's an opportunity to ask questions and understand your health better.

81 services81 patients

Aspiration and/or injection of fluid large joint using ultrasound guidance 20611

This procedure involves using ultrasound technology to accurately locate a large joint, usually the knee or shoulder. A needle is then inserted to either extract fluid (aspiration) or inject medication. The ultrasound helps ensure precision and safety.

76 services61 patients

New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more 99203

This service involves an initial office or outpatient visit for a new patient. The healthcare professional will spend 30-44 minutes understanding your health history, current issues, and discussing possible treatment plans. It's a comprehensive evaluation to start your healthcare journey.

57 services57 patients

X-ray of shoulder, minimum of 2 views 73030

An X-ray of the shoulder, with a minimum of 2 views, is a non-invasive imaging test. It uses a small amount of radiation to produce images of your shoulder bones. This helps in diagnosing conditions like fractures, arthritis, or other abnormalities. The procedure is quick and painless.

50 services41 patients

X-ray of hip, 2-3 views 73502

An X-ray of the hip with 2-3 views is a non-invasive imaging test. It uses a small amount of radiation to produce pictures of the hip joint. These images help in diagnosing conditions like fractures, arthritis, or other abnormalities. The process is quick and painless.

46 services40 patients

X-ray of knee, 4 or more views 73564

An X-ray of the knee, 4 or more views, is a non-invasive imaging test. It involves capturing multiple images of your knee from different angles. This helps in diagnosing conditions such as fractures, arthritis, or infections. The procedure is quick and painless.

45 services39 patients

Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213

This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.

35 services32 patients

X-ray of hand, minimum of 3 views 73130

An X-ray of the hand, minimum of 3 views, is a non-invasive imaging test. It uses a small amount of radiation to produce images of the bones in your hand from different angles. This helps in diagnosing fractures, infections, arthritis, or other abnormalities. It's quick and painless.

23 services17 patients

X-ray of lower and sacral spine, 2-3 views 72100

An X-ray of the lower and sacral spine involves capturing images of your lower back area, including the tailbone. This procedure helps in identifying problems like fractures, infections, or deformities. 2-3 different angle views provide a comprehensive picture.

22 services21 patients

X-ray of wrist, minimum of 3 views 73110

An X-ray of the wrist, minimum of 3 views, is a diagnostic procedure that uses radiation to create images of your wrist from different angles. This helps detect fractures, infections, or other abnormalities for accurate diagnosis and treatment planning.

22 services19 patients

X-ray of foot, minimum of 3 views 73630

An X-ray of the foot, minimum of 3 views, is a non-invasive imaging test. It uses a small amount of radiation to produce images of the bones and tissues in your foot. This helps to identify fractures, infections, or other abnormalities. Multiple views ensure a comprehensive examination.

22 services19 patients

Aspiration and/or injection of fluid from medium joint using ultrasound guidance 20606

This is a procedure where a needle is guided by ultrasound into a medium-sized joint, like a knee or shoulder. The needle can be used to remove fluid, which can relieve pressure and pain, or to inject medication to help with inflammation and discomfort.

17 services17 patients

Injection into tendon or ligament 20550

An injection into a tendon or ligament involves placing medication directly into these areas to help reduce inflammation and pain. It's often used for conditions like arthritis or tendonitis. The procedure is quick and usually involves a local anesthetic.

15 services13 patients

Complete ultrasound scan of joint 76881

A complete ultrasound scan of a joint is a non-invasive procedure using sound waves to create images of your joint. It helps identify problems like inflammation, injury, or disease. It's painless, safe, and doesn't involve radiation.

13 services13 patients

X-ray of lower and sacral spine, minimum of 4 views 72110

An X-ray of the lower and sacral spine involves capturing images of your lower back and tailbone area. It helps in identifying issues like fractures, arthritis, or other abnormalities. At least four different angles or 'views' are taken to get a comprehensive picture.

12 services12 patients

X-ray of knee, 3 views 73562

An X-ray of the knee, 3 views, is a non-invasive imaging test. It uses a small amount of radiation to produce images of the knee from three different angles. This helps medical professionals to diagnose and monitor conditions like arthritis, fractures, or infections. The process is quick and painless.

12 services12 patients

Hospital Affiliations CMS Care Compare 3

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

Kootenai Health

Acute Care Hospitals · Coeur D'alene, ID

4/5 CMS rating

OwnershipGovernment - Hospital District or Authority

CMS Certification Number130049

Location2003 Kootenai Health WayCoeur D'alene, ID 83814 · Kootenai County

Emergency services Birthing friendly

Boundary Community Hospital

Critical Access Hospitals · Bonners Ferry, ID

OwnershipVoluntary non-profit - Other

CMS Certification Number131301

Location6640 Kaniksu StreetBonners Ferry, ID 83805 · Boundary County

Emergency services

Bonner General Hospital

Critical Access Hospitals · Sandpoint, ID

OwnershipVoluntary non-profit - Private

CMS Certification Number131328

Location520 North Third AvenueSandpoint, ID 83864 · Bonner County

Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 83852 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

$81.13 typical visit price

range $52.44 – $160.17

Typical copayment $20.28 (range $13.11 – $40.04)

Most-billed visit code 99203

Established Patient

$65.77 typical visit price

range $16.68 – $130.93

Typical copayment $16.44 (range $4.17 – $32.73)

Most-billed visit code 99213

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

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

0/100

MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program

Individually scored

Quality

Improvement Activities

Other Providers at the Same Location NPPES 11

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

DR. JOAN M BLOOM M.D.

Family Medicine

30544 HIGHWAY 200, SUITE 102
PONDERAY, ID 83852

Bonner County (208) 265-9817

MICHAEL R DIBENEDETTO MD PLLC

Surgery (Plastic and Reconstructive Surgery)

30544 HIGHWAY 200, SUITE 102
PONDERAY, ID 83852

Bonner County (208) 263-5900

KAUAI IN-HOME THERAPY LLC

Clinic/Center (Physical Therapy)