Diane Agnes Pankow, APRN-BC

Primary specialty

Primary Care Nurse PractitionerTaxonomy code 363LP2300X

License

149936 Issued in MA

Practice address

1071 Blue Hill Ave
Milton, MA 02186-2302

Phone

(617) 333-2182

NPI assigned

Apr 26, 2007

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Curry College

  • Student Health Clinic/Center
  • Milton, MA
  • NPI 1821449950
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1177545600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1013137520",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "81 COTTAGE ST",
            "city": "SHARON",
            "state": "MA",
            "postal_code": "020672132",
            "telephone_number": "781-784-8197"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1071 BLUE HILL AVE",
            "city": "MILTON",
            "state": "MA",
            "postal_code": "021862302",
            "telephone_number": "617-333-2182"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PANKOW",
        "first_name": "DIANE",
        "middle_name": "AGNES",
        "credential": "APRN-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-26",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "MA",
            "license": "149936",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kate Lyn Osullivan
• Out for Good, Inc.
• Linda Papoula Owens, D.C.
• Paul G Paganelli, M.D.
• Lucia Palm Sloane, PT, DPT
• Samantha J Pannenborg
• Jeffrey Pantano, DPM
• Natalie Joan Paris, APRN
• Benjamin Eric Pariser, ACNPC-AG, RN
• Toni Diane Parolisi, PMHNP-BC

• Primary Care Nurse Practitioner in Milton, MA
• Providers in Milton, MA by specialty
• Primary Care Nurse Practitioner in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.