Individual provider Active NPI

James John Diresta, DPM, MPH

  • Podiatrist
  • Newburyport, MA
National Provider Identifier
1164460374
Registry record updated Oct 22, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
1523 Issued in MA
Practice address
37 1/2 Forrester St
Professional Building
Newburyport, MA 01950-1938
Phone
(978) 465-2122
Fax
(978) 465-0450
NPI assigned
Jun 2, 2006
Last updated
Oct 22, 2015By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 22, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X 1523 MA Primary

Addresses

Primary practice location

37 1/2 Forrester St
Professional Building
Newburyport, MA 01950-1938

Mailing address

37 1/2 Forrester Street
Professional Building
Newburyport, MA 01950
Phone (978) 465-2122

Other identifiers 2

IdentifierTypeStateIssuer
Y70643OtherMABLUE SHIELD
702862OtherMATAHP

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1523MAMDPhysician Assistant

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1149206400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1445472000000",
    "number": "1164460374",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "37 1/2 FORRESTER STREET",
            "address_2": "PROFESSIONAL BUILDING",
            "city": "NEWBURYPORT",
            "state": "MA",
            "postal_code": "01950",
            "telephone_number": "978-465-2122"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "37 1/2 FORRESTER ST",
            "address_2": "PROFESSIONAL BUILDING",
            "city": "NEWBURYPORT",
            "state": "MA",
            "postal_code": "019501938",
            "telephone_number": "978-465-2122",
            "fax_number": "978-465-0450"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIRESTA",
        "first_name": "JAMES",
        "middle_name": "JOHN",
        "name_prefix": "Dr.",
        "credential": "DPM, MPH",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-02",
        "last_updated": "2015-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "MA",
            "license": "1523",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "Y70643",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TAHP",
            "identifier": "702862",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Newburyport, MA

Sources for this page

Verify at the official NPI Registry.