Provider Demographics
NPI:1770588477
Name:DIPASQUALE, THOMAS G (DO)
Entity type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:G
Last Name:DIPASQUALE
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
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Mailing Address - Street 1:1803 MOUNT ROSE AVE
Mailing Address - Street 2:SUITE B3
Mailing Address - City:YORK
Mailing Address - State:PA
Mailing Address - Zip Code:17403-3026
Mailing Address - Country:US
Mailing Address - Phone:717-851-1405
Mailing Address - Fax:717-812-4092
Practice Address - Street 1:25 MONUMENT RD
Practice Address - Street 2:SUITE 290
Practice Address - City:YORK
Practice Address - State:PA
Practice Address - Zip Code:17403-5060
Practice Address - Country:US
Practice Address - Phone:717-812-4090
Practice Address - Fax:717-812-4092
Is Sole Proprietor?:No
Enumeration Date:2005-06-17
Last Update Date:2016-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOS4860207X00000X, 207XX0801X
PAOS014568207X00000X, 207XX0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XX0801XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryOrthopaedic Trauma
No207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL061913200Medicaid
FL4206708OtherAETNA
PA578713OtherHIGHMARK BLUE SHIELD
PA102254603Medicaid
FL1109059OtherCIGNA
PA227273OtherJOHNS HOPKINS
PA261994OtherUNISON-WMG
PA50083202OtherCAPITAL BLUE CROSS-WMG
FL010032239OtherMEDICARE RAILROAD
PA1578893OtherGATEWAY-WMG
FL206359OtherAVMED
FL80165OtherBC/BS
PA123843OtherGEISINGER HEALTH PLAN
PA2084817OtherHIGHMARK BLUE SHIELD
MD646417OtherCAREFIRST MD BCBS
PA50083202OtherCAPITAL BLUE CROSS-WMG
PA102254603Medicaid
MD646417OtherCAREFIRST MD BCBS
PA143684FLTMedicare PIN
PA227273OtherJOHNS HOPKINS