MEDICARE: DR. THOMAS G DIPASQUALE DO

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207X00000X	Orthopaedic Surgery Physician	OS4860	FL
2	207XX0801X	Orthopaedic Trauma Physician	OS4860	FL
3	207X00000X	Orthopaedic Surgery Physician	OS014568	PA
4	207XX0801X	Orthopaedic Trauma Physician	OS014568	PA

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
9	010032239	OTHER	FL	MEDICARE RAILROAD

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	4206708	OTHER	FL	AETNA
3	578713	OTHER	PA	HIGHMARK BLUE SHIELD
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
5	1109059	OTHER	FL	CIGNA
6	227273	OTHER	PA	JOHNS HOPKINS
7	261994	OTHER	PA	UNISON-WMG
8	50083202	OTHER	PA	CAPITAL BLUE CROSS-WMG
10	1578893	OTHER	PA	GATEWAY-WMG
11	206359	OTHER	FL	AVMED
12	80165	OTHER	FL	BC/BS
13	123843	OTHER	PA	GEISINGER HEALTH PLAN
14	2084817	OTHER	PA	HIGHMARK BLUE SHIELD
15	646417	OTHER	MD	CAREFIRST MD BCBS

General Provider Information

NPI Number	:	1770588477
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. THOMAS G DIPASQUALE DO

Provider Business Mailing Address
First Line	:	1803 MOUNT ROSE AVE
Second Line	:	SUITE B3
City	:	YORK
State	:	PA
Zip	:	17403-3026
Country	:	US
Telephone Number	:	717-851-1405
Fax Number	:	717-812-4092

Provider Business Practice Location Address
First Line	:	25 MONUMENT RD
Second Line	:	SUITE 290
City	:	YORK
State	:	PA
Zip	:	17403-5060
Country	:	US
Telephone Number	:	717-812-4090
Fax Number	:	717-812-4092

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/17/2005
Last Update Date	:	06/30/2016

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