Provider Demographics
NPI:1932170115
Name:DIMARCO, ROSS F JR (MD)
Entity type:Individual
Prefix:DR
First Name:ROSS
Middle Name:F
Last Name:DIMARCO
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:127 ONEIDA VALLEY RD STE 201
Mailing Address - Street 2:
Mailing Address - City:BUTLER
Mailing Address - State:PA
Mailing Address - Zip Code:16001-2239
Mailing Address - Country:US
Mailing Address - Phone:724-431-4328
Mailing Address - Fax:724-431-2288
Practice Address - Street 1:1050 BOWER HILL RD STE 203
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15243-1868
Practice Address - Country:US
Practice Address - Phone:412-444-0098
Practice Address - Fax:412-444-0111
Is Sole Proprietor?:No
Enumeration Date:2006-01-27
Last Update Date:2018-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD-015833E208G00000X
PA174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Yes208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA77785OtherUS HEALTHCARE
OH0611207OtherMEDICAID
OH0611207Medicaid
PA1003920OtherGATEWAY HEALTH PLAN
PA100777OtherUPMC HEALTH PLANS
PA060008937OtherMEDICARE RAILROAD
PA171016101OtherBEST HEALTH
PA66164OtherTHREE RIVERS HEALTH PLAN
PA060008973OtherPHCS
PAC30272OtherHEALTH AMERICA/ASSURANCE
PA0006946540002Medicaid
PA0006946540004Medicaid
PA171016101OtherINTERGROUP
PA106193OtherHIGHMARK/KEYSTONE
PA1003920OtherGATEWAY HEALTH PLAN
PA66164OtherTHREE RIVERS HEALTH PLAN
OH0611207OtherMEDICAID