Marvia Rosemarie McDonald-Dias

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

0000000100034388 Issued in CT

Practice address

211 Schraffts Dr Lowr Level
Waterbury, CT 06705-3287

Phone

(203) 518-8218

NPI assigned

Oct 27, 2022

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in CT

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

Specialty

Nurse Practitioner

Education

Other, 2022

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Viarepose Mental Health & Wellness LLC

  • Psychiatric/Mental Health Nurse Practitioner
  • Manchester, CT
  • NPI 1609672518
  Medicare reassignment Authorized official
• Impact Health Psych PC

  • Psychiatric/Mental Health Nurse Practitioner
  • Orange, CT
  • NPI 1730781022
  Medicare reassignment NPD
• WCT Behavioral Health & Medication Management PLLC

  dba WCT Health & Wellness

  • Family Nurse Practitioner
  • Waterbury, CT
  • NPI 1285391474
  Medicare reassignment NPD

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

{
    "created_epoch": "1666828800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1740096000000",
    "number": "1326765538",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "436 WOODLAND ST",
            "city": "MANCHESTER",
            "state": "CT",
            "postal_code": "060422865",
            "telephone_number": "860-374-8538"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "211 SCHRAFFTS DR LOWR LEVEL",
            "city": "WATERBURY",
            "state": "CT",
            "postal_code": "067053287",
            "telephone_number": "203-518-8218"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCDONALD-DIAS",
        "first_name": "MARVIA",
        "middle_name": "ROSEMARIE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-10-27",
        "last_updated": "2025-02-21",
        "certification_date": "2025-02-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WP0808X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health",
            "state": "CT",
            "license": "92948",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CT",
            "license": "0000000100034388",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Joseph McCullough, MD
• Bianca McDaniel, LPCA
• Michelle B McDermott Lyons
• Kevin Barry McDermott, RN
• Lindsey McDermott, BS
• Neysa J. McDonald
• Robert J McDonald, MD
• Deshawn McFarlane
• Fahmida Khan McGann, DO
• Shannon Marie McGourn, APRN

• Nurse Practitioner in Waterbury, CT
• Providers in Waterbury, CT by specialty
• Nurse Practitioner in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 2025; 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.