Individual provider Active NPI

Judith A Dimarco, RNFNP

  • Obstetrics & Gynecology Nurse Practitioner
  • Oswego, NY
National Provider Identifier
1629004635
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology Nurse PractitionerTaxonomy code 363LX0001X
License
F332019 Issued in NY
Practice address
42 Montcalm St
Oswego, NY 13126-1321
Phone
(315) 343-2590
Fax
(315) 343-4197
NPI assigned
Jun 23, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Nurse Practitioner 363LX0001X F332019 NY Primary

Addresses

Primary practice location

42 Montcalm St
Oswego, NY 13126-1321

Mailing address

42 Montcalm St
Oswego, NY 13126-1321
Phone (315) 343-2590

Other identifiers 2

IdentifierTypeStateIssuer
01816155MedicaidNY
F332019OtherNYLICENSE

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)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
F332019NYMDObstetrics & Gynecology Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1151020800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1629004635",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "42 MONTCALM ST",
            "city": "OSWEGO",
            "state": "NY",
            "postal_code": "131261321",
            "telephone_number": "315-343-2590",
            "fax_number": "315-343-4197"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "42 MONTCALM ST",
            "city": "OSWEGO",
            "state": "NY",
            "postal_code": "131261321",
            "telephone_number": "315-343-2590",
            "fax_number": "315-343-4197"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIMARCO",
        "first_name": "JUDITH",
        "middle_name": "A",
        "name_prefix": "Mrs.",
        "credential": "RNFNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-23",
        "last_updated": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LX0001X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Obstetrics & Gynecology",
            "state": "NY",
            "license": "F332019",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01816155",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "F332019",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Oswego, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; 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.