Individual provider Active NPI

Kristine Dimiero

  • Clinical Social Worker
  • Springfield, MA
National Provider Identifier
1740686732
Registry record updated Nov 20, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Practice address
110 Maple St
Springfield, MA 01105-1864
Phone
(413) 732-7419
Fax
(413) 781-1059
NPI assigned
Nov 18, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 20, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X Primary

Addresses

Primary practice location

110 Maple St
Springfield, MA 01105-1864

Mailing address

110 Maple St
Springfield, MA 01105-1864
Phone (413) 732-7419

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: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250107000725 MA Practitioner - Clinical Social Worker 8921536889 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Panda Bugs, Inc. Clinical CurrentSince May 18, 2025 Accepting new patients
413Therapy Group, Inc. Clinical CurrentSince Dec 13, 2024 Accepting new patients

Locations

280 N Main St
Ste 6
East Longmeadow, MA 01028
Phone (413) 342-0882

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1416268800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1511136000000",
    "number": "1740686732",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 MAPLE ST",
            "city": "SPRINGFIELD",
            "state": "MA",
            "postal_code": "011051864",
            "telephone_number": "413-732-7419",
            "fax_number": "413-781-1059"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 MAPLE ST",
            "city": "SPRINGFIELD",
            "state": "MA",
            "postal_code": "011051864",
            "telephone_number": "413-732-7419",
            "fax_number": "413-781-1059"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIMIERO",
        "first_name": "KRISTINE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-11-18",
        "last_updated": "2017-11-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Springfield, MA

Sources for this page

Verify at the official NPI Registry.