Individual provider Active NPI

Justin Dilibero, MSN, RN, CNS-BC

  • Clinical Nurse Specialist
  • Boston, MA
National Provider Identifier
1598215584
Registry record updated Oct 13, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Nurse SpecialistTaxonomy code 364S00000X
License
RN258365 Issued in MA
Practice address
330 Brookline Ave
Boston, MA 02215-5400
Phone
(617) 632-7024
NPI assigned
Oct 13, 2016
Last updated
Oct 13, 2016By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 13, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Nurse Specialist 364S00000X RN258365 MA Primary
Acute Care Clinical Nurse Specialist 364SA2100X RN258365 MA

Addresses

Primary practice location

330 Brookline Ave
Boston, MA 02215-5400

Mailing address

330 Brookline Ave
Boston, MA 02215-5400
Phone (617) 632-7024

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
Credentials
Master of Science - Nursing, Registered Nurse

State licenses

LicenseStateTypeSpecialty
RN258365MAMDClinical Nurse Specialist

NPI Registry JSON

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

{
    "created_epoch": "1476316800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1476316800000",
    "number": "1598215584",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "330 BROOKLINE AVE",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "022155400",
            "telephone_number": "617-632-7024"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "330 BROOKLINE AVE",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "022155400",
            "telephone_number": "617-632-7024"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DILIBERO",
        "first_name": "JUSTIN",
        "name_prefix": "Mr.",
        "credential": "MSN, RN, CNS-BC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-10-13",
        "last_updated": "2016-10-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "364S00000X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist",
            "state": "MA",
            "license": "RN258365",
            "primary": true
        },
        {
            "code": "364SA2100X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Acute Care",
            "state": "MA",
            "license": "RN258365",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boston, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 13, 2016; 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.