Individual provider Active NPI

Diana Russell Murphy, AUD

  • Audiologist
  • Brockton, MA
National Provider Identifier
1699175307
Registry record updated Jul 30, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
AudiologistTaxonomy code 231H00000X
License
1068 Issued in MA
Practice address
35 Pearl St Ste 100
Brockton, MA 02301-2866
Phone
(508) 588-8034
Fax
(508) 588-5969
NPI assigned
Aug 29, 2014
Last updated
Jul 30, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 30, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Audiologist 231H00000X AUD00214 RI
Audiologist 231H00000X 1068 MA Primary

Addresses

Primary practice location

35 Pearl St Ste 100
Brockton, MA 02301-2866

Mailing address

35 Pearl St Ste 100
Brockton, MA 02301-1195
Phone (508) 588-8034

Other names 1

  • Diana Russell Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20151102002487 MA Practitioner - Qualified Audiologist 7113149402 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Qualified Audiologist
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
ENT Specialists, IncGroup PAC ID 0648353888, 20 clinicians

Practice addresses (Care Compare)

35 Pearl St
Suite 200
Brockton, MA 02301-2866
Phone (508) 588-8034

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1068MAMDRegistered Dietitian

Organizations & group practices 2

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": "1409270400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1596067200000",
    "number": "1699175307",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "35 PEARL ST STE 100",
            "city": "BROCKTON",
            "state": "MA",
            "postal_code": "023011195",
            "telephone_number": "508-588-8034",
            "fax_number": "508-588-5969"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "35 PEARL ST STE 100",
            "city": "BROCKTON",
            "state": "MA",
            "postal_code": "023012866",
            "telephone_number": "508-588-8034",
            "fax_number": "508-588-5969"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MURPHY",
        "first_name": "DIANA",
        "middle_name": "RUSSELL",
        "credential": "AUD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-08-29",
        "last_updated": "2020-07-30",
        "certification_date": "2020-07-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "RI",
            "license": "AUD00214",
            "primary": false
        },
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "MA",
            "license": "1068",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DIANA",
            "last_name": "RUSSELL",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Brockton, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 30, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.