Active NPI
Jesse Lee Dimick, PTA, LATC
- Sports Medicine (Physical Medicine & Rehabilitation) Physician
- West Roxbury, MA
National Provider Identifier
1386680809
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Sports Medicine (Physical Medicine & Rehabilitation) Physician
- License
- 1708
- Practice address
- 43 Redlands Rd
West Roxbury, MA 02132-1506 - Phone
- (617) 892-2749
- NPI assigned
- Jun 22, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Sports Medicine (Physical Medicine & Rehabilitation) Physician | 2081S0010X | 1708 | MA | Primary |
Addresses
Primary practice location
43 Redlands Rd
West Roxbury, MA 02132-1506
Mailing address
43 Redlands Rd
West Roxbury, MA 02132-1506
Phone (617) 892-2749
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1708 | MA | MD | Podiatrist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1150934400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1783900800000",
"number": "1386680809",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "43 REDLANDS RD",
"city": "WEST ROXBURY",
"state": "MA",
"postal_code": "021321506",
"telephone_number": "617-892-2749"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "43 REDLANDS RD",
"city": "WEST ROXBURY",
"state": "MA",
"postal_code": "021321506",
"telephone_number": "617-892-2749"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DIMICK",
"first_name": "JESSE",
"middle_name": "LEE",
"name_prefix": "Mr.",
"credential": "PTA, LATC",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-06-22",
"last_updated": "2026-07-13",
"status": "A"
},
"taxonomies": [
{
"code": "2081S0010X",
"taxonomy_group": "",
"desc": "Physical Medicine & Rehabilitation, Sports Medicine",
"state": "MA",
"license": "1708",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in West Roxbury, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.