Individual provider Active NPI

Bermesola M Dyer, APRN

  • Family Nurse Practitioner
  • Laurel, MD
National Provider Identifier
1205170206
Registry record updated Apr 8, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
R158722 Issued in MD
Practice address
372 Main St
Laurel, MD 20707-4133
Phone
(240) 294-4079
NPI assigned
Nov 15, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 8, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 95003221 CA
Family Nurse Practitioner 363LF0000X R158722 MD Primary

Addresses

Primary practice location

372 Main St
Laurel, MD 20707-4133

Mailing address

372 Main St
Laurel, MD 20707-4133
Phone (240) 294-4079

Other practice location 1

576 E El Camino Real
Sunnyvale, CA 94087-1940
Phone (408) 739-4620

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC
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
I20130109000077 DC Practitioner - Nurse Practitioner 8729231436 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

372 Main St
Laurel, MD 20707-4133
Phone (240) 294-4079

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Custom Made Weight Loss and Nursing Solutions Family CurrentSince Aug 25, 2020 Accepting new patients
Minuteclinic LLC Family CurrentSince Sep 15, 2012 Accepting new patients

Locations

1911 Towne Centre Blvd
Annapolis, MD 21401
Phone (443) 837-3540

2601 Riva Rd
Annapolis, MD 21401
Phone (410) 571-2090

580 Marketplace Dr
Bel Air, MD 21014
Phone (410) 420-6296

10095 Ward Rd
Dunkirk, MD 20754
Phone (410) 257-0191

370 Main St
Ste 2
Laurel, MD 20707
Phone (240) 294-4079

413 Main St
Ste 3
Laurel, MD 20707
Phone (667) 256-5535

7955 Tuckerman Ln
Rockville, MD 20854
Phone (301) 299-3717

Organizations & group practices 2

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": "1352937600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1775606400000",
    "number": "1205170206",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "372 MAIN ST",
            "city": "LAUREL",
            "state": "MD",
            "postal_code": "207074133",
            "telephone_number": "240-294-4079",
            "fax_number": "240-559-0085"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "372 MAIN ST",
            "city": "LAUREL",
            "state": "MD",
            "postal_code": "207074133",
            "telephone_number": "240-294-4079"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "576 E El Camino Real",
            "address_purpose": "LOCATION",
            "city": "Sunnyvale",
            "state": "CA",
            "postal_code": "940871940",
            "country_code": "US",
            "telephone_number": "408-739-4620",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DYER",
        "first_name": "BERMESOLA",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-11-15",
        "last_updated": "2026-04-08",
        "certification_date": "2026-04-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95003221",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MD",
            "license": "R158722",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Laurel, MD

Sources for this page

Verify at the official NPI Registry.