Basic Information
| Provider Information | |||||||||
| NPI: | 1770588477 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | DIPASQUALE | ||||||||
| FirstName: | THOMAS | ||||||||
| MiddleName: | G | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | DO | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1803 MOUNT ROSE AVE | ||||||||
| Address2: | SUITE B3 | ||||||||
| City: | YORK | ||||||||
| State: | PA | ||||||||
| PostalCode: | 174033026 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7178511405 | ||||||||
| FaxNumber: | 7178124092 | ||||||||
| Practice Location | |||||||||
| Address1: | 25 MONUMENT RD | ||||||||
| Address2: | SUITE 290 | ||||||||
| City: | YORK | ||||||||
| State: | PA | ||||||||
| PostalCode: | 174035060 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7178124090 | ||||||||
| FaxNumber: | 7178124092 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/17/2005 | ||||||||
| LastUpdateDate: | 06/30/2016 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207X00000X | OS4860 | FL | N | Allopathic & Osteopathic Physicians | Orthopaedic Surgery | 207XX0801X | OS4860 | FL | Y | Allopathic & Osteopathic Physicians | Orthopaedic Surgery | Orthopaedic Trauma | 207X00000X | OS014568 | PA | N | Allopathic & Osteopathic Physicians | Orthopaedic Surgery | 207XX0801X | OS014568 | PA | N | Allopathic & Osteopathic Physicians | Orthopaedic Surgery | Orthopaedic Trauma |
ID Information
| ID | Type | State | Issuer | Description | 061913200 | 05 | FL | MEDICAID | 4206708 | 01 | FL | AETNA | OTHER | 578713 | 01 | PA | HIGHMARK BLUE SHIELD | OTHER | 102254603 | 05 | PA | MEDICAID | 1109059 | 01 | FL | CIGNA | OTHER | 227273 | 01 | PA | JOHNS HOPKINS | OTHER | 261994 | 01 | PA | UNISON-WMG | OTHER | 50083202 | 01 | PA | CAPITAL BLUE CROSS-WMG | OTHER | 010032239 | 01 | FL | MEDICARE RAILROAD | OTHER | 1578893 | 01 | PA | GATEWAY-WMG | OTHER | 206359 | 01 | FL | AVMED | OTHER | 80165 | 01 | FL | BC/BS | OTHER | 123843 | 01 | PA | GEISINGER HEALTH PLAN | OTHER | 2084817 | 01 | PA | HIGHMARK BLUE SHIELD | OTHER | 646417 | 01 | MD | CAREFIRST MD BCBS | OTHER |