Individual provider Active NPI

Kurt A Diebold, MD

  • Internal Medicine Physician
  • Lynn, MA
National Provider Identifier
1114993516
Registry record updated Jan 19, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
213606 Issued in MA
Practice address
235 Woodland N FL 2
Lynn, MA 01904-1414
Phone
(781) 715-6608
NPI assigned
Feb 24, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 19, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 213606 MA Primary

Addresses

Primary practice location

235 Woodland N FL 2
Lynn, MA 01904-1414

Mailing address

26 Whitney Tavern Rd
Weston, MA 02493-2136
Phone (774) 270-2799

Other practice location 1

166 Central St
Lowell, MA 01852-1910
Phone (978) 513-7300

Other identifiers 2

IdentifierTypeStateIssuer
0172863MedicaidMA
110005966AMedicaidMA

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20041206000704 MA Practitioner - Internal Medicine 7315903929

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Tufts University School of Medicine, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Chelmsford Family Practice, PCGroup PAC ID 7113997396, 11 clinicians

Practice addresses (Care Compare)

10 Adams St
North Chelmsford, MA 01863-1780
Phone (978) 251-3159

Hospital & facility affiliations

  • Emerson Hospital - Hospital, W Concord, MA, CCN 220084

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
213606MAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Nantucket Cottage Hospital CurrentSince Jan 1, 2019 Accepting new patients
Emerson Practice Associates, Inc. Internal Medicine CurrentSince Feb 1, 2011 Accepting new patients
Nantucket Cottage Hospital CurrentSince Jan 1, 2019 Accepting new patients
Chelmsford Family Practice, PC CurrentSince Jul 1, 2026 Accepting new patients
Baystate Medical Practices, Inc Internal Medicine Past Accepting new patients
Mercy Inpatient Medical Associates Inc. Internal Medicine PastSince Aug 17, 2020 Accepting new patients

Locations

41 Mall Rd
Burlington, MA 01805
Phone (781) 744-8400

133 Ornac
Concord, MA 01742
Phone (978) 287-3000

57 Prospect St
Nantucket, MA 02554
Phone (508) 228-1200

10 Adams St
North Chelmsford, MA 01863
Phone (978) 251-3159

Interoperability endpoints

  • Direct secure messaging: kurt.diebold.p1@direct.elementcare.nextgenshare.com

Organizations & group practices 6

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1140739200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1737244800000",
    "number": "1114993516",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26 WHITNEY TAVERN RD",
            "city": "WESTON",
            "state": "MA",
            "postal_code": "024932136",
            "telephone_number": "774-270-2799"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "235 WOODLAND N FL 2",
            "city": "LYNN",
            "state": "MA",
            "postal_code": "019041414",
            "telephone_number": "781-715-6608"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "166 Central St",
            "address_purpose": "LOCATION",
            "city": "Lowell",
            "state": "MA",
            "postal_code": "018521910",
            "country_code": "US",
            "telephone_number": "978-513-7300",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DIEBOLD",
        "first_name": "KURT",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-24",
        "last_updated": "2025-01-19",
        "certification_date": "2025-01-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MA",
            "license": "213606",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0172863",
            "state": "MA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "110005966A",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lynn, MA

Sources for this page

Verify at the official NPI Registry.