Marylouise Demick

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

RN146131 Issued in MA

Practice address

417 Liberty St
Springfield, MA 01104-3736

Phone

(413) 736-3668

Fax

(413) 731-8651

NPI assigned

Dec 31, 2015

Last updated

Dec 31, 2015By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Specialty

Nurse Practitioner

Education

Other, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Waltham Behavioral Health LLCGroup PAC ID 7315233822, 8 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Waltham Behavioral Health LLC

  • Adult Psychiatric/Mental Health Registered Nurse
  • Waltham, MA
  • NPI 1427453000
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1451520000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1451520000000",
    "number": "1538524848",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "417 LIBERTY ST",
            "city": "SPRINGFIELD",
            "state": "MA",
            "postal_code": "011043736",
            "telephone_number": "413-736-3668",
            "fax_number": "413-731-8651"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "417 LIBERTY ST",
            "city": "SPRINGFIELD",
            "state": "MA",
            "postal_code": "011043736",
            "telephone_number": "413-736-3668",
            "fax_number": "413-731-8651"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEMICK",
        "first_name": "MARYLOUISE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-12-31",
        "last_updated": "2015-12-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MA",
            "license": "RN146131",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jean E Demartinis, NP
• Liana Demartino
• Max Ryan Demartino, DPT
• Sean Demartino, PSY.D.
• Sara Demers, PA-C
• Kelly Jean Deming
• Peter T Demos, M.D.
• Demosthenes D. Dasco, MD, PC
• Daisy Margaret Dempsey, MD
• Ryan Houldsworth Dempsey, M.S.

• Psychiatric/Mental Health Nurse Practitioner in Springfield, MA
• Providers in Springfield, MA by specialty
• Psychiatric/Mental Health Nurse Practitioner in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 31, 2015; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.