NPIMap

Organization Active NPI

Demos Agiomavritis MD PC

  • Internal Medicine Physician
  • Worcester, MA
National Provider Identifier
1093786725
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
47165 Issued in MA
Legal business name
DEMOS AGIOMAVRITIS MD PC
Practice address
385 Grove St
Suite 120
Worcester, MA 01605-3924
Phone
(508) 770-8002
Fax
(508) 770-8006
NPI assigned
Jan 31, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Demosthenes K Agiomavritis, MDNPI 1386850691
Title
Physician President
Phone
(508) 770-8002

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X 47165 MA Primary

Addresses

Primary practice location

385 Grove St
Suite 120
Worcester, MA 01605-3924

Mailing address

385 Grove St
Suite 120
Worcester, MA 01605-3924
Phone (508) 770-8002

Other identifiers 9

IdentifierTypeStateIssuer
61250OtherHARVARD PILGRIM
9065240OtherPRIVATE HEALTH CARE
20787175OtherTAX ID
26373OtherFALLON
701827OtherTUFTS
999969OtherNETWORK HEALTH
9751530MedicaidMA
N01922OtherBLUE CROSS INDIVIDUAL
M18983OtherBCBS

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1138665600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1093786725",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "385 GROVE ST",
            "address_2": "SUITE 120",
            "city": "WORCESTER",
            "state": "MA",
            "postal_code": "016053924",
            "telephone_number": "508-770-8002",
            "fax_number": "508-770-8006"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "385 GROVE ST",
            "address_2": "SUITE 120",
            "city": "WORCESTER",
            "state": "MA",
            "postal_code": "016053924",
            "telephone_number": "508-770-8002",
            "fax_number": "508-770-8006"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DEMOS AGIOMAVRITIS MD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-01-31",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "AGIOMAVRITIS",
        "authorized_official_first_name": "DEMOSTHENES",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "PHYSICIAN PRESIDENT",
        "authorized_official_telephone_number": "508-770-8002",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "MA",
            "license": "47165",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HARVARD PILGRIM",
            "identifier": "61250",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PRIVATE HEALTH CARE",
            "identifier": "9065240",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TAX ID",
            "identifier": "20787175",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FALLON",
            "identifier": "26373",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TUFTS",
            "identifier": "701827",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NETWORK HEALTH",
            "identifier": "999969",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9751530",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS INDIVIDUAL",
            "identifier": "N01922",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "M18983",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Worcester, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.