Individual provider Active NPI

Claire Francesca Diilio, PMHNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Brockton, MA
National Provider Identifier
1396394854
Registry record updated Aug 11, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
RN2303629 Issued in MA
Practice address
529 Pearl St
Brockton, MA 02301-2825
Phone
(508) 580-2211
NPI assigned
Sep 8, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 11, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X RN2303629 MA
Psychiatric/Mental Health Nurse Practitioner 363LP0808X RN2303629 MA Primary

Addresses

Primary practice location

529 Pearl St
Brockton, MA 02301-2825

Mailing address

91 Auckland St Apt 1
Dorchester, MA 02125-4032
Phone (412) 629-6011

Medicare participation

Medicare enrollment files
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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20201001001239 MA Practitioner - Nurse Practitioner 7618396243 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Moonshot Psychiatric Nurse Practitioner PCGroup PAC ID 9335589696, 79 clinicians

Practice addresses (Care Compare)

77 Franklin St
Suite 809
Boston, MA 02110-1508
Phone (201) 748-2806

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
RN2303629MAMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Moonshot Psychiatric Nurse Practitioner PC Psychiatric/Mental Health CurrentSince May 13, 2025 Accepting new patients

Locations

77 Franklin St
Ste 809
Boston, MA 02110
Phone (617) 451-0055

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": "1567900800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1597104000000",
    "number": "1396394854",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "91 AUCKLAND ST APT 1",
            "city": "DORCHESTER",
            "state": "MA",
            "postal_code": "021254032",
            "telephone_number": "412-629-6011"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "529 PEARL ST",
            "city": "BROCKTON",
            "state": "MA",
            "postal_code": "023012825",
            "telephone_number": "508-580-2211"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIILIO",
        "first_name": "CLAIRE",
        "middle_name": "FRANCESCA",
        "credential": "PMHNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-09-08",
        "last_updated": "2020-08-11",
        "certification_date": "2020-08-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MA",
            "license": "RN2303629",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MA",
            "license": "RN2303629",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brockton, MA

Sources for this page

Verify at the official NPI Registry.