Individual provider Active NPI

Ashley Jean Demirali

  • Pediatric Nurse Practitioner
  • Hagerstown, MD
National Provider Identifier
1710559158
Registry record updated Dec 29, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
0024183880 Issued in VA
Practice address
1141 Opal CT
Hagerstown, MD 21740-5976
Phone
(301) 791-6666
NPI assigned
Jul 14, 2021
Last updated
Dec 29, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 29, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X R248622 MD
Pediatric Nurse Practitioner 363LP0200X 0024183880 VA Primary

Addresses

Primary practice location

1141 Opal CT
Hagerstown, MD 21740-5976

Mailing address

1141 Opal CT
Hagerstown, MD 21740-5976

Other identifiers 1

IdentifierTypeStateIssuer
1710559158MedicaidVA

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
I20230512000170 MA Practitioner - Nurse Practitioner 8527452127 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0024183880VAMDPediatric Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Atrius Health, Inc. CurrentSince Jun 12, 2023 Accepting new patients
Atrius Health, Inc. Current Accepting new patients
Opal Court Pediatrics, P.a. PastSince Jul 1, 2021 Accepting new patients

Locations

133 Brookline Ave
Boston, MA 02215
Phone (617) 421-1000

147 Milk St
Fl 9
Boston, MA 02109
Phone (617) 559-8051

1611 Cambridge St
Cambridge, MA 02138
Phone (617) 661-5100

Interoperability endpoints

  • Direct secure messaging: ademirali372154@direct.atrius.masshiway.net
  • FHIR API: https://api.platform.athenahealth.com/17459/brand/1/csg/1/fhir/r4

Organizations & group practices 3

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": "1626220800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1703808000000",
    "number": "1710559158",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1141 OPAL CT",
            "city": "HAGERSTOWN",
            "state": "MD",
            "postal_code": "217405976"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1141 OPAL CT",
            "city": "HAGERSTOWN",
            "state": "MD",
            "postal_code": "217405976",
            "telephone_number": "301-791-6666"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEMIRALI",
        "first_name": "ASHLEY",
        "middle_name": "JEAN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-07-14",
        "last_updated": "2023-12-29",
        "certification_date": "2023-12-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "MD",
            "license": "R248622",
            "primary": false
        },
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "VA",
            "license": "0024183880",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1710559158",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hagerstown, MD

Sources for this page

Verify at the official NPI Registry.