Stephen M Dierks, M.D.

Primary specialty

Urology PhysicianTaxonomy code 208800000X

License

150601 Issued in MA

Practice address

250 Green St Ste 104
Gardner, MA 01440-1377

Phone

(978) 669-5522

Fax

(978) 669-5521

NPI assigned

Nov 5, 2005

Last updated

Oct 30, 2018By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MA

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://app.meldrx.com/api/fhir/uc05634_metrowesturologicassoc

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.

• Henry Heywood Memorial Hospital

  dba Heywood Hospital

  • General Acute Care Hospital
  • Gardner, MA
  • NPI 1205823879
  Medicare reassignment NPD
• Heywood Medical Group Inc.

  • General Practice Physician
  • Gardner, MA
  • NPI 1699762286

  Urology

  Medicare reassignment NPD
• Skilled Facility Health Care Solutions Inc

  • Surgery Physician
  • Los Angeles, CA
  • NPI 1104018423

  MA

  Medicare reassignment NPD
• Henry Heywood Memorial Hospital

  dba Heywood Hospital

  • Psychiatric Hospital Unit
  • Gardner, MA
  • NPI 1457685299
  NPD
• Heywood Affiliated Medical Group Inc.

  dba Heywood Urgent Care

  • Urgent Care Clinic/Center
  • Gardner, MA
  • NPI 1215304589
  NPD
• Metrowest Urologic Associates PC

  • Urology Physician
  • Natick, MA
  • NPI 1710497383
  NPD (past)
• Metrowest Urology, P.C.

  • Urology Physician
  • Natick, MA
  • NPI 1780700518
  NPD (past)
• Umass Memorial Medical Group Inc

  • Internal Medicine Physician
  • Worcester, MA
  • NPI 1760445373
  NPD (past)
• LRG Healthcare

  • Ambulatory Surgical Clinic/Center
  • Laconia, NH
  • NPI 1942388327
  NPD (past)

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

{
    "created_epoch": "1131148800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1540857600000",
    "number": "1508857731",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1327",
            "city": "LACONIA",
            "state": "NH",
            "postal_code": "032471327",
            "telephone_number": "603-524-3211",
            "fax_number": "603-527-7038"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "250 GREEN ST STE 104",
            "city": "GARDNER",
            "state": "MA",
            "postal_code": "014401377",
            "telephone_number": "978-669-5522",
            "fax_number": "978-669-5521"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "724 N Main St",
            "address_purpose": "LOCATION",
            "city": "Laconia",
            "state": "NH",
            "postal_code": "032462742",
            "country_code": "US",
            "telephone_number": "603-524-5151",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DIERKS",
        "first_name": "STEPHEN",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-05",
        "last_updated": "2018-10-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "MA",
            "license": "150601",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3157695",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lucy K Delrossi, LCSW
• Raymond Laureat Demers Sr., LCSW
• Deborah J Depratti
• Melanie Pfaffinger Designas
• Quianna Jazmyne Diaz-Patterson, PA-C
• Brenda Dill, RN
• Alisha April Ditaranto
• Kerry Dodge
• Sarah Doiron
• Jennifer Marie Dominguez, RPH

• Urology Physician in Gardner, MA
• Providers in Gardner, MA by specialty
• Urology Physician in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.