MATTHEW L. DIVIETRO DO – NPI #1427265867
Internal Medicine

An internist who treats diseases of the lungs and airways. The pulmonologist diagnoses and treats cancer, pneumonia, pleurisy, asthma, occupational and environmental diseases, bronchitis, sleep disorders, emphysema and other complex disorders of the lungs.

Health Care Provider Taxonomy Code for Internal Medicine

MATTHEW DIVIETRO is a physician located in MERIDIAN, ID. NPPES has assigned the NPI number 1427265867 to MATTHEW DIVIETRO on May 16, 2007. It is a Type-1 NPI, indicating this NPI number is associated with an individual. With multiple taxonomy codes selected, the primary taxonomy selected by this provider is 207RP1001X from the Health Care Provider Taxonomy code set, which is classified as Internal Medicine, specializing in Pulmonary Disease

The NPI profile was previously updated about 4 years ago on Aug 24, 2022. Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for MATTHEW DIVIETRO below.

NPI Profile for
MATTHEW L. DIVIETRO

NPI Number
1427265867
Enumeration Date

(more than 19 years ago)
Entity Type
Type-1  Individual (Male)
Legal Name
MATTHEW L. DIVIETRO
Credentials
DO
Primary location
2347 E GALA ST
MERIDIAN, ID 83642-4881
Phone: (208) 323-3767 Fax:
1 Other location(s):
500 W Fort St
# 111
Boise, ID 83702
Phone: (208) 422-1000
Fax: (208) 422-1319
Mailing address
190 E BANNOCK ST
BOISE, ID 83712-6241
Phone: (208) 381-2222 Fax:
Sole Proprietor
No
Updated
Certification Date
Aug 24, 2022

Note: NPPES allows providers to attest to the accuracy of their NPI data. When a provider request any change to the NPI record, they will be able to attest to their changed NPI data, resulting in an updated certification date.

Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

Taxonomy Classification / Specialization State License
207RP1001X
- Internal Medicine / Pulmonary Disease (Primary)		 ID O 0727
207RC0200X
- Internal Medicine / Critical Care Medicine		 ID O 0727
207R00000X
- Internal Medicine		 ID O 0727

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.

Additional Information

Education
PHILADELPHIA COLLEGE OF OSTEOPATHIC MEDICINE - Graduated 2006
Accepts Medicare
This provider accepts Medicare-approved amount as payment in full. The Medicare-approved amount is the total the provider can be paid. When a provider accepts the Medicare-approved amount as payment, you won't be billed for more than the Medicare deductible & coinsureance.
Medicare Ordering & Referring
Provider can:
  • Refer to Part B
  • Order Durable Medical Equipment
  • Refer to Home Health Agency
  • Order Power Mobility Devices
Affiliations
MATTHEW DIVIETRO is affiliated with the following medical group(s):
  • HOSPITAL
    • GRANDE RONDE HOSPITAL
      900 SUNSET DRIVE
      LA GRANDE, OR 97850
    • ST LUKE'S NAMPA MEDICAL CENTER
      9850 WEST ST LUKES DRIVE
      NAMPA, ID 83687
    • ST LUKE'S REGIONAL MEDICAL CENTER
      190 EAST BANNOCK STREET
      BOISE, ID 83712

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