Individual provider Active NPI

Djenane Madmirka Pierre, PA

  • Physician Assistant
  • Ludlow, MA
National Provider Identifier
1104500024
Registry record updated Oct 21, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
471 Center St
Ludlow, MA 01056-2733
Phone
(413) 625-3500
Fax
(413) 625-3655
NPI assigned
Jun 12, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 21, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X MA Primary
Student in an Organized Health Care Education/Training Program 390200000X

Addresses

Primary practice location

471 Center St
Ludlow, MA 01056-2733

Mailing address

360 US Highway 1 Byp Unit 102
Portsmouth, NH 03801-7105
Phone (603) 410-6700

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250908003681 MA Practitioner - Physician Assistant 6002318060 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Convenientmd - FFS UC LLCGroup PAC ID 5193186492, 397 clinicians

Practice addresses (Care Compare)

139 Turnpike Rd
Westborough, MA 01581-2835
Phone (508) 882-7300

15 Pleasant Valley Rd
Sutton, MA 01590-2970
Phone (508) 426-9005

245 Hartford Ave
Bellingham, MA 02019-3007
Phone (774) 295-4355

40 Davis Straits
Falmouth, MA 02540-3906
Phone (774) 255-3010

471 Ctr St
Ludlow, MA 01056-2733
Phone (413) 625-3500

70 Gold Star Blvd
Worcester, MA 01606-2812
Phone (508) 426-9002

999 Dalton Ave
Pittsfield, MA 01201-2903
Phone (413) 242-6577

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Convenientmd - FFS UC LLC CurrentSince Jul 22, 2025 Accepting new patients

Locations

245 Hartford Ave
Bellingham, MA 02019
Phone (774) 295-4355

40 Davis Straits
Falmouth, MA 02540
Phone (774) 255-3010

471 Center St
Ludlow, MA 01056
Phone (413) 625-3500

360 US Highway 1 Byp
Unit 102
Portsmouth, NH 03801
Phone (603) 410-6700

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1686528000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1761004800000",
    "number": "1104500024",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "360 US HIGHWAY 1 BYP UNIT 102",
            "city": "PORTSMOUTH",
            "state": "NH",
            "postal_code": "038017105",
            "telephone_number": "603-410-6700",
            "fax_number": "603-319-8308"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "471 CENTER ST",
            "city": "LUDLOW",
            "state": "MA",
            "postal_code": "010562733",
            "telephone_number": "413-625-3500",
            "fax_number": "413-625-3655"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PIERRE",
        "first_name": "DJENANE",
        "middle_name": "MADMIRKA",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-06-12",
        "last_updated": "2025-10-21",
        "certification_date": "2025-10-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MA",
            "license": null,
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ludlow, MA

Sources for this page

Verify at the official NPI Registry.