Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Joseph J Dibernardo, PA-C

Individual provider Medical Physician Assistant · NPI 1497721419

Joseph J Dibernardo, PA-C is a Physician Assistant in Providence, Rhode Island. Qualified in 2003, 23 years ago. Practices with Lifespan Physician Group Inc, a 1,125-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in Rhode Island.

Years since qualifying
23
Licensed in
RI
In the registry since
2006
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

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Practice location Address checks out

164 Summit Ave # C70
Providence, RI 02906-2853
Phone: (401) 793-4545
Fax: (401) 793-7866
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 455 Toll Gate Rd, Warwick, RI 02886-2770 — (401) 737-7010

Specialties & licences

Medical Physician Assistant (primary) Taxonomy 363AM0700X · Licence PA00321 (RI)

Record details

NPI number1497721419
Entity typeIndividual (Type 1)
GenderMale
Credentials PA-C
Sole proprietorNo
NPI enumeratedFebruary 28, 2006
Last updated in NPPESDecember 2, 2025
Certification dateDecember 2, 2025

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2003 (23 years in practice)
Group practice Lifespan Physician Group Inc — 1125 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

Other providers in Providence