NPIMap

Individual provider Active NPI

Dino C Constantinou, MD

  • Internal Medicine Physician
  • Brockton, MA
National Provider Identifier
1770578932
Registry record updated Jul 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
136551 Issued in MA
Practice address
110 Liberty St
Brockton, MA 02301-5674
Phone
(508) 894-0400
Fax
(508) 894-0412
NPI assigned
Sep 14, 2005
Last updated
Jul 15, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 15, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 136551 MA Primary

Addresses

Primary practice location

110 Liberty St
Brockton, MA 02301-5674

Mailing address

110 Liberty St
Brockton, MA 02301-5674
Phone (508) 894-0400

Other practice location 1

1 Pearl St
Suite 2200
Brockton, MA 02301-2864
Phone (508) 897-6190

Other identifiers 1

IdentifierTypeStateIssuer
3184625MedicaidMA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040123000901 MA Practitioner - Internal Medicine 2769384296 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Boston University School of Medicine, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Signature Healthcare Medical Group IncGroup PAC ID 7719876267, 250 clinicians

Practice addresses (Care Compare)

110 Liberty St
Brockton, MA 02301-5521
Phone (508) 894-0400

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
136551MAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Steward Medical Group, Inc CurrentSince Dec 1, 2011 Accepting new patients
Signature Healthcare Medical Group Inc Internal Medicine CurrentSince Jul 1, 2024 Accepting new patients
Steward Medical Group, Inc CurrentSince Dec 1, 2011 Accepting new patients
Medical Care of Boston Management Corporation Internal Medicine Past Accepting new patients

Locations

11 Nevins St
Ste 201
Brighton, MA 02135
Phone (617) 789-2442

77 Warren St
Fl 5
Brighton, MA 02135
Phone (617) 254-3376

1 Pearl St
Ste 2200
Brockton, MA 02301
Phone (508) 897-6150

110 Liberty St
Brockton, MA 02301

680 Centre St
Brockton, MA 02302
Phone (508) 941-7400

104 Liberty St
Hanson, MA 02341
Phone (617) 293-5454

100 Amesbury St
Ste 103
Lawrence, MA 01840
Phone (978) 683-0157

907 Sumner St
Ste 202
Stoughton, MA 02072
Phone (781) 297-8020

Interoperability endpoints

  • Direct secure messaging: dino.constantinou@direct.signature.masshiway.net

Organizations & group practices 4

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.

Hospital & facility affiliations 13

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1126656000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721001600000",
    "number": "1770578932",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 LIBERTY ST",
            "city": "BROCKTON",
            "state": "MA",
            "postal_code": "023015674",
            "telephone_number": "508-894-0400",
            "fax_number": "508-894-0412"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 LIBERTY ST",
            "city": "BROCKTON",
            "state": "MA",
            "postal_code": "023015674",
            "telephone_number": "508-894-0400",
            "fax_number": "508-894-0412"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1 Pearl St",
            "address_2": "Suite 2200",
            "address_purpose": "LOCATION",
            "city": "Brockton",
            "state": "MA",
            "postal_code": "023012864",
            "country_code": "US",
            "telephone_number": "508-897-6190",
            "fax_number": "508-897-6175",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CONSTANTINOU",
        "first_name": "DINO",
        "middle_name": "C",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-14",
        "last_updated": "2024-07-15",
        "certification_date": "2024-07-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MA",
            "license": "136551",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3184625",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brockton, MA

Sources for this page

Verify at the official NPI Registry.