James L Demetroulakos, MD

Primary specialty

Otolaryngology PhysicianTaxonomy code 207Y00000X

License

79502 Issued in MA

Practice address

104 Endicott St
Suite 100
Danvers, MA 01923-3623

Phone

(978) 745-6601

Fax

(978) 624-4040

NPI assigned

Feb 10, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 9

Electronic endpoints 1

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

Specialty

Otolaryngology

Education

Warren Alpert Medical School of Brown University, 1985

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

North Shore Ear, Nose and Throat Associates, PCGroup PAC ID 9032138367, 17 clinicians

Atrius Health IncGroup PAC ID 4789588641, 1,214 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Northeast Hospital Corporation Hospital, Beverly, MA, CCN 220033
• Massachusetts General Hospital Hospital, Boston, MA, CCN 220071
• North Shore Medical Center - Hospital, Salem, MA, CCN 220035

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jdemetroulakos22063@direct.atrius.masshiway.net
• Direct secure messaging: demetroulakos.james.nsent@direct.partners.masshiway.net

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.

• Atrius Health, Inc.

  • Internal Medicine Physician
  • Boston, MA
  • NPI 1871639914
  Medicare reassignment Care Compare group NPD
• North Shore Ear, Nose & Throat Associates, PC

  • Otolaryngology Physician
  • Salem, MA
  • NPI 1619940780
  Medicare reassignment Care Compare group NPD
• Mass General Brigham Medical Group Northern Massachusetts Inc

  • Emergency Medicine Physician
  • Salem, MA
  • NPI 1588606123

  Otolaryngology

  Medicare reassignment NPD
• North Shore Ear, Nose & Throat Associates

  • Otolaryngology Physician
  • Danvers, MA
  • NPI 1447657564
  NPD
• Atrius Health, Inc.

  dba Harvard Vanguard Medical Associates

  • Internal Medicine Physician
  • Boston, MA
  • NPI 1740238526
  NPD (past)
• NSPG Billing LLC

  • Urology Physician
  • Newburyport, MA
  • NPI 1144981721
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• North Shore Medical Center, Inc.

  dba Salem Hospital

  • General Acute Care Hospital
  • Salem, MA
  • NPI 1730121633
  Care Compare affiliation
• Northeast Hospital Corporation

  • General Acute Care Hospital
  • Beverly, MA
  • NPI 1316917941
  Care Compare affiliation
• Northeast Hospital Corporation

  • Psychiatric Hospital Unit
  • Beverly, MA
  • NPI 1407827710
  Care Compare affiliation
• The General Hospital Corporation

  • General Acute Care Hospital
  • Boston, MA
  • NPI 1023049236
  Care Compare affiliation

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

{
    "created_epoch": "1139529600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1640736000000",
    "number": "1326011180",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "104 ENDICOTT ST",
            "address_2": "SUITE 100",
            "city": "DANVERS",
            "state": "MA",
            "postal_code": "019233623",
            "telephone_number": "781-639-3055"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "104 ENDICOTT ST",
            "address_2": "SUITE 100",
            "city": "DANVERS",
            "state": "MA",
            "postal_code": "019233623",
            "telephone_number": "978-745-6601",
            "fax_number": "978-624-4040"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEMETROULAKOS",
        "first_name": "JAMES",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-10",
        "last_updated": "2021-12-29",
        "certification_date": "2021-12-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "MA",
            "license": "79502",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTH NUMBER",
            "identifier": "1000021",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HARVARD PILGRIM",
            "identifier": "19486",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "2084343",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NEIGHBORHOOD HEALTH NUMBE",
            "identifier": "0012294",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE NUMBER",
            "identifier": "040006919",
            "state": "MA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3129101",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TUFTS NUMBER",
            "identifier": "079502",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FALLON NUMBER",
            "identifier": "34544",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD NUMBER",
            "identifier": "J30549",
            "state": "MA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "Demetroulakos.James.NSENT@direct.partners.masshiway.net",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "address_1": "104 Endicott St",
            "address_2": "Suite 100",
            "city": "Danvers",
            "state": "MA",
            "country_code": "US",
            "postal_code": "019233623",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Della Mente Therapeutics
• Maribeth Deltorchio
• David Deluca
• Kayla Delvecchio
• Cassandra Isabelle Demers
• Kristen Demoranville
• Jenna Lynn Denapoli
• Pamela Denham
• Cara Jean Denisco, OTR/L
• Courtney Denoncour

• Otolaryngology Physician in Danvers, MA
• Providers in Danvers, MA by specialty
• Otolaryngology Physician in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 29, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.