NPI age
19 years
Enumerated 2006-11-13
● Active
Type 1 · Individual
Michael Raymond Dibenedetto, M.D.
Dibenedetto is 1 of 2 orthopaedic surgery providers in Ponderay and 1 of 239 in Idaho.
Primary specialty
Orthopaedic Surgery
Licensed in
ID
1 state
Status
Active
No deactivations on record
Last NPPES update
2013-04-03
Source: monthly bulk 2026-05
Sole proprietor
No
May be part of a larger org
How this provider compares
Across 239 active orthopaedic surgery providers in Idaho.
NPI age
19 years
≈ at median (19 yr)
State licenses
1 state
25% of peers hold multiple states
Subspecialties
0
45% of peers hold subspecialties
NPI lifetime · 2006 → 2026
2006-11Enumerated in NPPES
2006
2026
Where they practice
Practice location
30544 Highway 200, Ste 102
Ponderay, ID 838525005
Mailing address
30544 Highway 200, Ste 102
Ponderay, ID 838525005
Specialties
-
Orthopaedic Surgery PrimaryAn orthopaedic surgeon is trained in the preservation, investigation and restoration of the form and function of the extremities, spine and associated structures by medical, surgical and physical means. An orthopaedic surgeon is...
Identifiers
| Type | Value | Notes |
|---|---|---|
| 01 (ID) | 77010 | BLUE CROSS |
| 05 (ID) | 806452000 | |
| 01 (ID) | P00042698 | PALMETTOGBA RAILROAD MEDI |
| 01 (ID) | 000010140056 | REGENCE |
Practice context
Part of a multi-provider practice. 11 other active providers share this practice address in NPPES.
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