Individual provider Active NPI

Prema Helen Dimauro, PTA

  • Skilled Nursing Facility
  • Phoenix, AZ
National Provider Identifier
1497900260
Registry record updated Nov 20, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
License
AT3119 Issued in CA
Practice address
7540 N 19TH Ave Ste 200
Phoenix, AZ 85021-7967
Phone
(888) 873-4221
NPI assigned
Nov 20, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 20, 2008

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X AT3119 CA Primary
Skilled Nursing Facility 314000000X AT 3119 CA

Addresses

Primary practice location

7540 N 19TH Ave Ste 200
Phoenix, AZ 85021-7967

Mailing address

3051 Sunflower Cir W
Palm Springs, CA 92262-1773
Phone (760) 416-9838

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

LicenseStateTypeSpecialty
AT 3119CAMDSkilled Nursing Facility
AT3119CAMDSkilled Nursing Facility

NPI Registry JSON

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

{
    "created_epoch": "1227139200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1227139200000",
    "number": "1497900260",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3051 SUNFLOWER CIR W",
            "city": "PALM SPRINGS",
            "state": "CA",
            "postal_code": "922621773",
            "telephone_number": "760-416-9838"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7540 N 19TH AVE STE 200",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850217967",
            "telephone_number": "888-873-4221"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIMAURO",
        "first_name": "PREMA",
        "middle_name": "HELEN",
        "credential": "PTA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-11-20",
        "last_updated": "2008-11-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "CA",
            "license": "AT3119",
            "primary": true
        },
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "CA",
            "license": "AT 3119",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 20, 2008; 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.