Teresa Ann Dimodica, MSN, NP-C, RN

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

RN2267894 Issued in MA

Practice address

1 Harborside Dr
Boston, MA 02128-2907

Phone

(844) 977-3725

NPI assigned

May 25, 2021

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

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science - Nursing, Registered Nurse

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

{
    "created_epoch": "1621900800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1621900800000",
    "number": "1649845355",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "45 DESOTO RD",
            "city": "WEST ROXBURY",
            "state": "MA",
            "postal_code": "021326004",
            "telephone_number": "617-910-7970"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 HARBORSIDE DR",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021282907",
            "telephone_number": "844-977-3725"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIMODICA",
        "first_name": "TERESA",
        "middle_name": "ANN",
        "credential": "MSN, NP-C, RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-05-25",
        "last_updated": "2021-05-25",
        "certification_date": "2021-01-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MA",
            "license": "RN2267894",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Noelle Catherine Dimitri, LICSW
• Irene Dimitriadis, M.D.
• Helena Dimitriou, PA
• Dimitris Zourdos DMD PC
• Dimo Dimchev Dimitrov, M.D.
• Ivan Petrov Dimov
• Ryan Din, MD
• Shai Dina
• Pradeep Dinakar, MD, MS, MBA
• Gabrielle Rose Dinapoli

• Nurse Practitioner in Boston, MA
• Providers in Boston, MA by specialty
• Nurse Practitioner in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 25, 2021; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.