Individual provider Active NPI

Ciara Irene Dimou, R.N., N.P.

  • Adult Health Nurse Practitioner
  • Burlington, MA
National Provider Identifier
1194135111
Registry record updated Mar 12, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
RN2284486 Issued in MA
Practice address
41 Mall Road
Lahey Hospital and Medical Center
Burlington, MA 01805-0001
Phone
(781) 744-7000
Fax
(781) 744-5351
NPI assigned
Apr 29, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 12, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X RN2284486 MA Primary
Women's Health Nurse Practitioner 363LW0102X RN2284486 MA

Addresses

Primary practice location

41 Mall Road
Lahey Hospital and Medical Center
Burlington, MA 01805-0001

Mailing address

421 Merrimack St
Suite 201
Methuen, MA 01844-5864
Phone (978) 725-4822

Other identifiers 1

IdentifierTypeStateIssuer
110100418AMedicaidMA

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
I20140910000554 MA Practitioner - Nurse Practitioner 5597984336 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner, Registered Nurse

State licenses

LicenseStateTypeSpecialty
RN2284486MAMDWomen's Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Merrimack Valley Medical Associates, PC CurrentSince Mar 1, 2015 Accepting new patients

Locations

421 Merrimack St
Ste 201
Methuen, MA 01844
Phone (978) 725-4822

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/EHJJAA

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1398729600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1520812800000",
    "number": "1194135111",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "421 MERRIMACK ST",
            "address_2": "SUITE 201",
            "city": "METHUEN",
            "state": "MA",
            "postal_code": "018445864",
            "telephone_number": "978-725-4822"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "41 MALL ROAD",
            "address_2": "LAHEY HOSPITAL AND MEDICAL CENTER",
            "city": "BURLINGTON",
            "state": "MA",
            "postal_code": "018050001",
            "telephone_number": "781-744-7000",
            "fax_number": "781-744-5351"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIMOU",
        "first_name": "CIARA",
        "middle_name": "IRENE",
        "name_prefix": "Miss",
        "credential": "R.N., N.P.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-04-29",
        "last_updated": "2018-03-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "MA",
            "license": "RN2284486",
            "primary": true
        },
        {
            "code": "363LW0102X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Women's Health",
            "state": "MA",
            "license": "RN2284486",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "110100418A",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Burlington, MA

Sources for this page

Verify at the official NPI Registry.