Active NPI
Dianne K Demers, PA
- Physician Assistant
- Worcester, MA
National Provider Identifier
1649221599
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 1183
- Practice address
- 26 Queen St
Worcester, MA 01610-2473 - Phone
- (508) 756-6324
- NPI assigned
- May 15, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 1183 | MA | Primary |
Addresses
Primary practice location
26 Queen St
Worcester, MA 01610-2473
Mailing address
390 Main St Ste 509
Worcester, MA 01608-2581
Phone (508) 756-6324
Other identifiers 8
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 42523 | Other | CHILDRENS MEDICAL SECURIT | |
| 042472266 | Other | THREE RIVERS | |
| 042472266 | Other | TRICARE CHAMPUS | |
| 381306 | Other | MVP HEALTH CARE | |
| 67868 | Other | FALLON COMMUNITY HEALTH P | |
| 8301692 | Other | EVERCARE | |
| AP2101 | Other | MEDICARE B | |
| 42523 | Other | HEALTHY START |
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
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1183 | MA | MD | Marriage & Family Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1147651200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1429833600000",
"number": "1649221599",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "390 MAIN ST STE 509",
"city": "WORCESTER",
"state": "MA",
"postal_code": "016082581",
"telephone_number": "508-756-6324"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "26 QUEEN ST",
"city": "WORCESTER",
"state": "MA",
"postal_code": "016102473",
"telephone_number": "508-756-6324"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DEMERS",
"first_name": "DIANNE",
"middle_name": "K",
"credential": "PA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-05-15",
"last_updated": "2015-04-24",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "MA",
"license": "1183",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CHILDRENS MEDICAL SECURIT",
"identifier": "42523",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "THREE RIVERS",
"identifier": "042472266",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TRICARE CHAMPUS",
"identifier": "042472266",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MVP HEALTH CARE",
"identifier": "381306",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "FALLON COMMUNITY HEALTH P",
"identifier": "67868",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "EVERCARE",
"identifier": "8301692",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE B",
"identifier": "AP2101",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HEALTHY START",
"identifier": "42523",
"state": null
}
],
"endpoints": [],
"other_names": []
}Other providers in Worcester, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 24, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.