Individual provider Active NPI

Brooke E Di Anni, D.O.

  • Pediatrics Physician
  • Auburn, MA
National Provider Identifier
1174580302
Registry record updated Mar 13, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
227008 Issued in MA
Practice address
385 Southbridge St
Auburn, MA 01501-2498
Phone
(508) 832-5917
Fax
(508) 832-5751
NPI assigned
May 1, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 13, 2019

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 227008 MA Primary

Addresses

Primary practice location

385 Southbridge St
Auburn, MA 01501-2498

Mailing address

5 Neponset St FL Street2
Worcester, MA 01606-2714
Phone (508) 832-5917

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
I20060907000163 MA Practitioner - Pediatric Medicine 5991709867 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
227008MAMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Reliant Medical Group, Inc Pediatrics CurrentSince Aug 10, 2010 Accepting new patients
Children'S Hospital Pediatric Associates, Inc Pediatrics PastSince Oct 22, 2023 Accepting new patients
Reliant Medical Group, Inc Past Accepting new patients
Caritas Medical Group, Inc. Past Accepting new patients

Locations

4 Brotherton Way
Auburn, MA 01501
Phone (508) 425-5446

385 Southbridge St
Auburn, MA 01501
Phone (508) 721-1101

630 Plantation St
Fl 12
Worcester, MA 01605
Phone (508) 368-5529

5 Neponset St
#2
Worcester, MA 01606

630 Plantation St
Worcester, MA 01605
Phone (508) 368-5529

5 Neponset St
Worcester, MA 01606
Phone (508) 595-2300

Interoperability endpoints

  • Direct secure messaging: brooke.dianni.npi1174580302.reliant@direct.optumcare.masshiway.net

Organizations & group practices 4

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": "1146441600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1552435200000",
    "number": "1174580302",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5 NEPONSET ST FL STREET2",
            "city": "WORCESTER",
            "state": "MA",
            "postal_code": "016062714",
            "telephone_number": "508-832-5917",
            "fax_number": "508-832-5751"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "385 SOUTHBRIDGE ST",
            "city": "AUBURN",
            "state": "MA",
            "postal_code": "015012498",
            "telephone_number": "508-832-5917",
            "fax_number": "508-832-5751"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DI ANNI",
        "first_name": "BROOKE",
        "middle_name": "E",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-01",
        "last_updated": "2019-03-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MA",
            "license": "227008",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Auburn, MA

Sources for this page

Verify at the official NPI Registry.