DR. BEN R DIMICHINO DPM
NPI 1760593867
Podiatrist in East Setauket, NY
NPI Status: Active since August 31, 2006
Contact Information
35 SHORE RD
EAST SETAUKET, NY
ZIP 11733
Phone: (631) 689-0202
Fax: (631) 689-2686
- Individual
- Male
- Years of Experience 35
- Podiatrist
- PECOS Enrolled
- Accepts Medicare Approved Payment
About BEN DIMICHINO
Ben Dimichino is a provider established in East Setauket, New York and his medical specialization is Podiatrist with more than 35 years of experience. He graduated from Temple University School Of Medicine in 1989. The healthcare provider is registered in the NPI registry with number 1760593867 assigned on August 2006. The practitioner's primary taxonomy code is 213E00000X with license number N004656 (NY). The provider is registered as an individual and his NPI record was last updated 15 years ago.
- NPI
- 1760593867
- Provider Name
- DR. BEN R DIMICHINO DPM
- Gender
- Male
- Entity Type
- Individual
- Location Address
- 35 SHORE RD EAST SETAUKET, NY 11733
- Location Phone
- (631) 689-0202
- Location Fax
- (631) 689-2686
- Mailing Address
- 35 SHORE RD EAST SETAUKET, NY 11733
- Mailing Phone
- (631) 689-0202
- Mailing Fax
- (631) 689-2686
- Medical School Name
- TEMPLE UNIVERSITY SCHOOL OF MEDICINE
- Graduation Year
- 1989
- Is Sole Proprietor?
- No
- Enumeration Date
- 08-31-2006
- Last Update Date
- 04-02-2009
- Code Navigator
A podiatrist like Ben Dimichino provides medical and surgical care for people with foot, ankle, and lower leg issues. Podiatrists treat foot and ankle ailments like calluses, ingrown toenails, heel spurs, arthritis, congenital foot deformities, foot problems associated with diabetes and arch problems.
Ben Dimichino is registered with Medicare and accepts claims assignment, this means the provider accepts the approved amount for the cost of rendered services as full payment. Participating providers may not charge beneficiaries more than the approved amount for their services. Please keep in mind that beneficiaries still have to pay a coinsurance or copayment amount for a visit or service.
The typical physician office visit costs for Medicare beneficiaries in this area are: $27.39 for a new patient copayment and $22.04 for an established patient copayment.
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Podiatrist
- Taxonomy Code
- 213E00000X
- Type
- Podiatric Medicine & Surgery Service Providers
- License No.
- N004656
- License State
- NY
- Taxonomy Description
- A podiatrist is a person qualified by a Doctor of Podiatric Medicine (D.P.M.) degree, licensed by the state, and practicing within the scope of that license. Podiatrists diagnose and treat foot diseases and deformities. They perform medical, surgical and other operative procedures, prescribe corrective devices and prescribe and administer drugs and physical therapy.
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
Medicare
Medicaid
Aetna
Oxford Health Plans
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
Additional Identifiers
The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.
| Identifier | Type / Code | Identifier State | Identifier Issuer |
|---|---|---|---|
| AA47838 | OTHER (01) | MDNY | |
| P51092 | MEDICARE PIN (08) | NY | |
| 1C1330 | OTHER (01) | HEALTH NET | |
| 01590385 | MEDICAID (05) | NY | |
| 4450726 | OTHER (01) | AETNA | |
| 114212 | OTHER (01) | VYTRA | |
| P51091 | MEDICARE ID-TYPE UNSPECIFIED (04) | NY | |
| 792279 | OTHER (01) | UNITED HEALTH CARE | |
| P2545365 | OTHER (01) | OXFORD | |
| U18040 | MEDICARE UPIN (02) |
PECOS Enrollment and Medicare Participation Status
Ben Dimichino is enrolled in PECOS and is eligible to order or refer health care services for Medicare patients. The provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME) and a Home Health Agency (HHA).
What is PECOS?
PECOS is the online Medicare enrollment management system or Provider, Enrollment, Chain and Ownership System. The PECOS system is a database of providers who have registered with CMS as providers or suppliers. PECOS is the primary source of information about verified Medicare professionals. Providers that want to participate in this program need to enroll in PECOS with their NPI number to avoid denied claims.
Is the provider registered in PECOS? Yes
PECOS PAC ID: 5890723928
What is the PECOS Associate Control ID?
A PAC ID is a unique 10-digit number assigned to an individual or organization healthcare provider in PECOS. The PAC ID is used to link together all the provider information, like tax identification numbers and organizational names. A PAC ID can be connected to multiple Enrollment IDs if an individual or organization has enrolled in PECOS more than once.PECOS Enrollment ID: I20050809000015
What is the Provider Enrollment ID?
The Enrollment ID is a unique alphanumeric 15-digit code assigned to each new provider's PECOS enrollment application. The Enrollment ID is used to link together all the provider enrollment information like enrollment type, state, provider specialty, and reassignment of benefits.Accepts Medicare Assignment? Yes
What does it mean "accepts medicare assignment"?
When a provider accepts Medicare assignment, the provider agrees to be paid directly by Medicare and to accept the payment amount approved by Medicare. Additionally, the provider agrees to not bill patients for more than the Medicare deductible and coinsurance amounts.
A provider who doesn't accept assignment may charge you up to 15% over the Medicare-approved amount. This is known as the limiting charge. You may have to pay this amount, or it may be covered by another insurer.Eligible to Order or Refer Part B Clinical Laboratory and Imaging: Yes
Eligible to Order or Refer Durable Medical Equipment (DMEPOS): Yes
Eligible to Order or Refer a Home Health Agency (HHA): Yes
Eligible to Order or Refer Power Mobility Devices: No
Physician Visit Costs
The pricing information below displays the copayment minimum, maximum and average amount that patients under Medicare are charged when visiting this provider as a new or established patient. Please keep in mind that these prices are just for reference purposes, and the actual prices charged by the provider might be different.
For patients covered under private health plans the prices below are also useful as healthcare pricing for private insurance is usually established as a function of Medicare prices. Private insurance covered patients should check their individual plans to determine the exact pricing.
The prices below reflect the costs for new and established patients in the 11733 ZIP code area.
New Patients Visit Costs *
The most utilized procedure code for new patients office visits is 99203
- Average New Patient Price $109.58
- Minimum New Patient Price $71.49
- Maximum New Patient Price $215.02
- Average New Patient Copayment $27.39
- Minimum New Patient Copayment $17.87
- Maximum New Patient Copayment $53.75
Established Patients Visit Costs *
The most utilized procedure code for established patients office visits is 99213
- Average Established Patient Price $88.17
- Minimum Established Patient Price $22.05
- Maximum Established Patient Price $174.06
- Average Established Patient Copayment $22.04
- Minimum Established Patient Copayment $5.51
- Maximum Established Patient Copayment $43.51
* The physician office visit costs information is generated by statistical analysis of similar providers in the same geographical area. The pricing information above IS NOT the amount charged by this provider.
Clinician Services
The following Healthcare Common Procedure Coding System (HCPCS) codes were publicly reported as the top services rendered by this provider under the Medicare program for the year 2020. The reported codes are based on the top 5 codes for each available specialty, excluding evaluation and management codes.
- 165
Removal of tissue from 6 or more finger or toe nails (HCPCS:11721)
- 40
Injection, triamcinolone acetonide, not otherwise specified, 10 mg (HCPCS:J3301)
- 39
Removal of tissue from 1 to 5 finger or toe nails (HCPCS:11720)
- 24
Injection, dexamethasone sodium phosphate, 1 mg (HCPCS:J1100)
- 20
Removal of 2 to 4 thickened skin growths (HCPCS:11056)
- 15
Removal of single thickened skin growth (HCPCS:11055)
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NPI Validation Check Digit Calculation
The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.
| Start with the original NPI number, the last digit is the check digit and is not used in the calculation. | |||||||||
| 1 | 7 | 6 | 0 | 5 | 9 | 3 | 8 | 6 | 7 |
| Step 1: Double the value of the alternate digits, beginning with the rightmost digit. | |||||||||
| 2 | 7 | 12 | 0 | 10 | 9 | 6 | 8 | 12 | |
| Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24. | |||||||||
| 2 + 7 + 1 + 2 + 0 + 1 + 0 + 9 + 6 + 8 + 1 + 2 + 24 = 63 | |||||||||
| Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit. | |||||||||
| 70 - 63 = 7 | 7 | ||||||||
The NPI number 1760593867 is valid because the calculated check digit 7 using the Luhn validation algorithm matches the last digit of the original NPI number.
Other Providers at the Same Location
The following provider is registered at the same or nearby location.
| NPI | Name / Type | Taxonomy | Address |
|---|---|---|---|
| 1336732056 | SACCOMANNO PODIATRY PLLC Organization | Podiatrist | 35 SHORE RD EAST SETAUKET, NY 11733 (631) 689-0202 |
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1760593867, enumerated in the NPI registry as an "individual" on August 31, 2006
The provider is located at 35 Shore Rd East Setauket, Ny 11733 and the phone number is (631) 689-0202
The provider's speciality is Podiatrist with taxonomy code 213E00000X
The provider has more than 35 years of experience. He graduated from Temple University School Of Medicine in 1989.
The provider might be accepting Accepts: Medicare, Medicaid, Aetna and Oxford Health Plans. Please consult your insurance carrier or call the provider to make sure your health plan is currently accepted.
Yes, as of May 10, 2024 the provider is registered in PECOS and is eligible to order health care services or supplies for Medicare patients. If you are a beneficiary the provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME) and a Home Health Agency (HHA).
Medicare beneficiaries should expect a typical cost of $109.58 with an average copayment of $27.39 for new patient appointments. Established patients should expect a typical charge of $88.17 and an average copayment of 22.04. Please review your insurance plan or contact the provider directly to determine your specific costs.
The most common procedures or services performed by this practitioner are: Removal of tissue from 6 or more finger or toe nails, Injection, triamcinolone acetonide, not otherwise specified, 10 mg, Removal of tissue from 1 to 5 finger or toe nails, Injection, dexamethasone sodium phosphate, 1 mg, Removal of 2 to 4 thickened skin growths and Removal of single thickened skin growth.
This NPI record was last updated on August 31, 2006. To officially update your NPI information contact the National Plan and Provider Enumeration System (NPPES) at 1-800-465-3203 (NPI Toll-Free) or by email at [email protected].
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