Michael R Dibenedetto MD PLLC
NPI 1073757464 · Plastic and Reconstructive Surgery Physician · Ponderay, ID
Michael R Dibenedetto MD PLLC is a Plastic and Reconstructive Surgery Physician organization in Ponderay, ID (NPI 1073757464).
Provider details
- NPI number
- 1073757464
- Entity type
- Organization
- Primary specialty
- Plastic and Reconstructive Surgery PhysicianAllopathic & Osteopathic Physicians
- Parent organization
- Michael R Dibenedetto MD PLLC
- Organization subpart
- Yes
- Authorized official
- Wendy Brosnahan, Office Manager(208) 263-5900
- License
- M10671 (ID)
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
17 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
Mailing address
Other names (DBA / former)
- Doing business as
- Seasons Plastic & Reconstructive Surgery
Registry dates
- Enumerated
- 2009-04-29
- Last updated
- 2009-10-21
Frequently asked questions
- What is Michael R Dibenedetto MD PLLC's NPI number?
- Michael R Dibenedetto MD PLLC's National Provider Identifier (NPI) is 1073757464, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Michael R Dibenedetto MD PLLC?
- Michael R Dibenedetto MD PLLC is classified in the NPPES registry as Plastic and Reconstructive Surgery Physician (Allopathic & Osteopathic Physicians).
- Where is Michael R Dibenedetto MD PLLC located?
- Michael R Dibenedetto MD PLLC's practice location on file with NPPES is 30544 Highway 200, Ponderay, ID 83852-5005.
- What is Michael R Dibenedetto MD PLLC's phone number?
- The practice phone number listed in the NPPES registry for Michael R Dibenedetto MD PLLC is (208) 263-5900.
- Who is the authorized official for Michael R Dibenedetto MD PLLC?
- The authorized official listed on Michael R Dibenedetto MD PLLC's NPPES record is Wendy Brosnahan, Office Manager. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Michael R Dibenedetto MD PLLC's NPI active?
- Yes — Michael R Dibenedetto MD PLLC's NPI (1073757464) is active in the NPPES registry as of the last update on 2009-10-21.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.