Individual provider Active NPI

Alycia Dymond, RN, IBCLC

  • Pediatric Nurse Practitioner
  • Beverly, MA
National Provider Identifier
1598389884
Registry record updated Jan 29, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
RN2304530 Issued in MA
Practice address
147 Colon St
Beverly, MA 01915-3632
Phone
(415) 894-9029
NPI assigned
Jun 2, 2020
Last updated
Jan 29, 2026By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 29, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X RN2304530 MA Primary

Addresses

Primary practice location

147 Colon St
Beverly, MA 01915-3632

Mailing address

147 Colon St
Beverly, MA 01915-3632
Phone (415) 894-9029

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
I20260402000634 MA Practitioner - Nurse Practitioner 9234614728 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2005
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

30 Tozer Rd
Suite 101
Beverly, MA 01915-5510

30 Tozer Rd
Suite 101
Beverly, MA 01915-5514

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
RN2304530MAMDPediatric Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Pediatric Associates of Greater Salem, Inc Past Accepting new patients

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/2804/brand/1/csg/1/fhir/r4

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": "1591056000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1769644800000",
    "number": "1598389884",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "147 COLON ST",
            "city": "BEVERLY",
            "state": "MA",
            "postal_code": "019153632",
            "telephone_number": "415-894-9029"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "147 COLON ST",
            "city": "BEVERLY",
            "state": "MA",
            "postal_code": "019153632",
            "telephone_number": "415-894-9029"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DYMOND",
        "first_name": "ALYCIA",
        "credential": "RN, IBCLC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-06-02",
        "last_updated": "2026-01-29",
        "certification_date": "2026-01-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "MA",
            "license": "RN2304530",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Beverly, MA

Sources for this page

Verify at the official NPI Registry.