Individual provider Active NPI

Diane E Grasso, NP

  • Family Nurse Practitioner
  • Athol, MA
National Provider Identifier
1417965765
Registry record updated May 24, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
191199 Issued in MA
Practice address
201 S Main St Ste 1
Athol, MA 01331-2117
Phone
(978) 249-0099
Fax
(978) 249-7227
NPI assigned
Aug 3, 2006
Last updated
May 24, 2016By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 24, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 191199 MA Primary
Family Medicine Physician 207Q00000X 191199 MA

Addresses

Primary practice location

201 S Main St Ste 1
Athol, MA 01331-2117

Mailing address

201 S Main St Ste 1
Athol, MA 01331-2117
Phone (978) 249-0099

Other names 1

  • Diane E Tellier Other name

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
I20070919000196 MA Practitioner - Nurse Practitioner 4082708268 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
191199MAMDFamily Medicine Physician

Interoperability endpoints

  • Direct secure messaging: diane.grasso@nqfp.eclinicaldirectplus.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.

NPI Registry JSON

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

{
    "created_epoch": "1154563200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1464048000000",
    "number": "1417965765",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "201 S MAIN ST STE 1",
            "city": "ATHOL",
            "state": "MA",
            "postal_code": "013312117",
            "telephone_number": "978-249-0099",
            "fax_number": "978-249-7227"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 S MAIN ST STE 1",
            "city": "ATHOL",
            "state": "MA",
            "postal_code": "013312117",
            "telephone_number": "978-249-0099",
            "fax_number": "978-249-7227"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRASSO",
        "first_name": "DIANE",
        "middle_name": "E",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-03",
        "last_updated": "2016-05-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MA",
            "license": "191199",
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MA",
            "license": "191199",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DIANE",
            "last_name": "TELLIER",
            "middle_name": "E",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Athol, MA

Sources for this page

Verify at the official NPI Registry.