Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Dr. Devlin Alexander Dizacomo, DPT

Individual provider Physical Therapist · NPI 1023593902

Dr. Devlin Alexander Dizacomo, DPT is a Physical Therapist in Private Practice in Indio, California. Qualified in 2018, 8 years ago. Practices with Intermountain Medical Group Denver LLC, a 567-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in California, Colorado and New York.

Years since qualifying
8
Licensed in
CA, CO, NY
In the registry since
2018
Specialties on file
3
What do these letters mean?
DPT — Doctor of Physical Therapy
The doctoral degree now required to enter physical therapy practice.

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Practice location Address checks out

81557 Dr Carreon Blvd Ste C4
Indio, CA 92201-5562
Phone: (760) 347-6195
Fax: (760) 347-2849
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 1076 Ribaut Rd Ste 102, Beaufort, SC 29902-5490 — (843) 525-0045

Specialties & licences

Physical Therapist (primary) Taxonomy 225100000X · Licence PT304810 (CA)
Physical Therapist Taxonomy 225100000X · Licence 043117 (NY)
Physical Therapist Taxonomy 225100000X · Licence PTL.0018134 (CO)

Record details

NPI number1023593902
Entity typeIndividual (Type 1)
GenderMale
Credentials DPT
Sole proprietorNo
NPI enumeratedSeptember 26, 2018
Last updated in NPPESFebruary 9, 2024
Certification dateFebruary 9, 2024
Mailing address408 Higuera St Ste 200, San Luis Obispo, CA 93401-6135

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICAL THERAPIST IN PRIVATE PRACTICE
Medical schoolOTHER
Graduated 2018 (8 years in practice)
Group practice Intermountain Medical Group Denver Llc — 567 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

Other providers in Indio