Individual provider Active NPI

Diane Belder-Preston

  • Pediatrics Physician
  • Boston, MA
National Provider Identifier
1144574955
Registry record updated Aug 10, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
253678 Issued in MA
Practice address
55 Fruit St
Yawkey Center for Outpatient Care, Suite 6D
Boston, MA 02114-2621
Phone
(617) 726-2728
NPI assigned
Oct 31, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 10, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 253678 MA Primary

Addresses

Primary practice location

55 Fruit St
Yawkey Center for Outpatient Care, Suite 6D
Boston, MA 02114-2621

Mailing address

55 Fruit St
Yawkey Center for Outpatient Care, Suite 6D
Boston, MA 02114-2621
Phone (617) 726-2728

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
I20130213000273 MA Practitioner - Pediatric Medicine 6507010816 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
253678MAMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
The General Hospital Corporation CurrentSince Dec 13, 2012 Accepting new patients
Massachusetts General Physicians Organization Inc Pediatrics CurrentSince Dec 13, 2012 Accepting new patients
Newton Wellesley Family Pediatrics Pediatrics Past Accepting new patients

Locations

55 Fruit St
Boston, MA 02114

55 Fruit St
Ste 6D
Boston, MA 02114
Phone (617) 726-2728

55 Fruit St
#2
Boston, MA 02114
Phone (617) 726-2967

Organizations & group practices 3

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": "1351641600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1470787200000",
    "number": "1144574955",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "55 FRUIT ST",
            "address_2": "YAWKEY CENTER FOR OUTPATIENT CARE, SUITE 6D",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021142621",
            "telephone_number": "617-726-2728"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "55 FRUIT ST",
            "address_2": "YAWKEY CENTER FOR OUTPATIENT CARE, SUITE 6D",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021142621",
            "telephone_number": "617-726-2728"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BELDER-PRESTON",
        "first_name": "DIANE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-10-31",
        "last_updated": "2016-08-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MA",
            "license": "253678",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boston, MA

Sources for this page

Verify at the official NPI Registry.