Individual provider Active NPI

Demosthenes Agiomavritis, M.D.

Internal Medicine Physician
Worcester, MA

National Provider Identifier

1386850691

Registry record updated Nov 2, 2020

On this page

Key facts
NPPES NPI Registry
Medicare participation
National Provider Directory
Organizations & group practices1
NPI Registry JSON
Other providers in Worcester, MA
Sources for this page

Key facts

NPPES NPI Registry

Primary specialty: Internal Medicine PhysicianTaxonomy code 207R00000X
License: 47165 Issued in MA
Practice address: 367 Plantation St
Worcester, MA 01605-2323
Phone: (508) 334-1443
Fax: (508) 334-1448
NPI assigned: May 15, 2007
Last updated: Nov 2, 2020By the provider in NPPES
Sex: Male
Sole proprietor: No

NPPES NPI Registry

Updated by the provider on Nov 2, 2020

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
Internal Medicine Physician	207R00000X	47165	MA	Primary

Addresses

Primary practice location

367 Plantation St
Worcester, MA 01605-2323

Mailing address

PO Box 415348
Boston, MA 02241-5348
Phone (800) 225-8885

Other identifiers 15

Identifier	Type	State	Issuer
2078767	Medicaid	MA
M18983	Other	MA	BLUE CROSS
202787175	Other	MA	AETNA
9751530	Medicaid	MA
202787175	Other	MA	CHAMPUS
61250	Other	MA	HARVARD PILGRIM
202787175	Other	MA	TAX ID
202787175	Other	MA	UNITED HEALTHCARE
202787175	Other	MA	GREAT WEST
701827	Other	MA	TUFTS
999969	Other	MA	NETWORK HEALTH
202787175	Other	MA	CIGNA
26373	Other	MA	FALLON
202787175	Other	MA	NETWORK HEALTH
N01922	Other	MA	BLUE CROSS

Electronic endpoints 2

Type	Endpoint	Use	Affiliation
Direct Messaging Address	dagiomavritis22068@UmassMemorial.direct-ci.com
FHIR URL	https://epicproxy.et0978.epichosted.com/FHIRProxy/api/FHIR/DSTU2/

Medicare participation

Medicare enrollment files

Medicare fee-for-service enrollment: Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD): Enrolled
Credentials: Doctor of Medicine

Practice roles

Organization	Specialty	Status	New patients
Demos Agiomavritis MD PC	Internal Medicine	PastSince Aug 1, 2005	Accepting new patients

Interoperability endpoints

Direct secure messaging: dagiomavritis22068@umassmemorial.direct-ci.com

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Demos Agiomavritis MD PC
- Internal Medicine Physician
- Worcester, MA
- NPI 1093786725
NPD (past) Authorized official

NPI Registry JSON

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

{
    "created_epoch": "1179187200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1604275200000",
    "number": "1386850691",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 415348",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "022415348",
            "telephone_number": "800-225-8885",
            "fax_number": "508-334-1977"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "367 PLANTATION ST",
            "city": "WORCESTER",
            "state": "MA",
            "postal_code": "016052323",
            "telephone_number": "508-334-1443",
            "fax_number": "508-334-1448"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AGIOMAVRITIS",
        "first_name": "DEMOSTHENES",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-15",
        "last_updated": "2020-11-02",
        "certification_date": "2020-11-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MA",
            "license": "47165",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2078767",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "M18983",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "202787175",
            "state": "MA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9751530",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CHAMPUS",
            "identifier": "202787175",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HARVARD PILGRIM",
            "identifier": "61250",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TAX ID",
            "identifier": "202787175",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE",
            "identifier": "202787175",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GREAT WEST",
            "identifier": "202787175",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TUFTS",
            "identifier": "701827",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NETWORK HEALTH",
            "identifier": "999969",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "202787175",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FALLON",
            "identifier": "26373",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NETWORK HEALTH",
            "identifier": "202787175",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "N01922",
            "state": "MA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "dagiomavritis22068@UmassMemorial.direct-ci.com",
            "affiliation": "N",
            "address_1": "367 Plantation St",
            "city": "Worcester",
            "state": "MA",
            "country_code": "US",
            "postal_code": "016052323",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicproxy.et0978.epichosted.com/FHIRProxy/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "367 Plantation St",
            "city": "Worcester",
            "state": "MA",
            "country_code": "US",
            "postal_code": "016052323",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Worcester, MA

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 2, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.