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DR. GARY P DIBENEDETTO DC
NPI 1790890580
Chiropractor in Port Jefferson Station, NY

Active since August 20, 2006
298 CANAL RD, PORT JEFFERSON STATION, NY 11776(631) 928-0192(631) 928-0253 Get Directions Write a Review

NPPES record last updated: December 12, 2008. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Dr. Gary P Dibenedetto Dc NPPES

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

DR. GARY P DIBENEDETTO DC (NPI 1790890580) is an individual chiropractor in Port Jefferson Station, New York, licensed in New York (X006475) and active in the NPI registry since August 2006. He is a graduate of New York Chiropractic College (1990).

NPPES Registry Identity

NPI1790890580
Entity TypeIndividualMale
Primary Taxonomy111N00000X
Provider Legal NameDR. GARY P DIBENEDETTOCredential: DC
Location Address298 CANAL RDPort Jefferson Station, NY 11776
Mailing Address298 Canal RdPort Jefferson Station, NY 11776 · (631) 928-0192 · Fax (631) 928-0253
Phone(631) 928-0192
Fax(631) 928-0253
Sole ProprietorYes
Medical School CMSNew York Chiropractic CollegeGraduated 1990
Enumeration DateAugust 20, 2006
Last NPPES UpdateDecember 12, 2008
✔ NPI 1790890580 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyChiropractorChiropractic Providers
Taxonomy Code111N00000X
License✔ Licensed in NY · X006475
Definition
A provider qualified by a Doctor of Chiropractic (D.C.), licensed by the State and who practices chiropractic medicine -that discipline within the healing arts which deals with the nervous system and its relationship to the spinal column and its interrelationship with other body systems.
298 CANAL RD, Port Jefferson Station, NY 11776
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Other Identifiers 2

Medicare UPINU33867
Medicare PINX48731NY

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Gary P Dibenedetto Dc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID8628250024
PECOS Enrollment IDI20110307000405

Medicare Billing Reassignment

Medicare enrollment records show Gary Dibenedetto reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

North Shore Chiropractic P.C.
Same address
Chiropractor
298 CANAL RD
Port Jefferson Station, NY 11776
  • Reassigned Medicare billing, New York enrollment
NPI 1598982373 (631) 928-0192

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Areas of Expertise CMS Part B claims 2

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.

Chiropractic manipulative treatment, 3-4 spinal regions 98941
Chiropractic manipulative treatment for 3-4 spinal regions involves a trained professional applying controlled force to specific areas of your spine. This can help alleviate pain, improve physical function, and support your body's natural healing process.
1,384 services79 patients
Chiropractic manipulative treatment, 1-2 spinal regions 98940
Chiropractic manipulative treatment focuses on adjusting your spine to improve your body's physical function. In this service, a chiropractor applies controlled force to 1-2 spinal regions. This helps to restore mobility and alleviate discomfort in those areas.
191 services17 patients

Other Providers at the Same Location NPPES

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

NORTH SHORE CHIROPRACTIC P.C.
Chiropractor
298 CANAL RD
PORT JEFFERSON STATION, NY 11776
Suffolk County (631) 928-0192

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 Gary Dibenedetto's NPI number?

The NPI number for Gary Dibenedetto is 1790890580. It was assigned to this individual provider in the NPPES registry on August 20, 2006.

Where is Gary Dibenedetto located?

Gary Dibenedetto practices at 298 Canal Rd, Port Jefferson Station, NY 11776. The listed phone number is (631) 928-0192.

What is Gary Dibenedetto's specialty?

The primary specialty registered for this NPI is Chiropractor with taxonomy code 111N00000X.

Is Gary Dibenedetto enrolled in Medicare?

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

Which organization bills Medicare for Gary Dibenedetto's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Gary Dibenedetto reassigns Medicare benefits to North Shore Chiropractic P.C. (Port Jefferson Station, NY). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Gary Dibenedetto's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Gary Dibenedetto was last updated on December 12, 2008. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 17 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.