Active NPI
Belden Louis Divito, P.A.
- Surgical Physician Assistant
- Leominster, MA
National Provider Identifier
1831131382
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgical Physician Assistant
- License
- 216
- Practice address
- 105 Erdman Way
Leominster, MA 01453-1805 - Phone
- (978) 537-7552
- Fax
- (978) 537-7383
- NPI assigned
- Jun 11, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgical Physician Assistant | 363AS0400X | 216 | MA | Primary |
Addresses
Primary practice location
105 Erdman Way
Leominster, MA 01453-1805
Mailing address
1 Edward St
Canton, MA 02021-2303
Phone (781) 828-3533
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 216 | MA | MD | Emergency Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1149984000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1338422400000",
"number": "1831131382",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1 EDWARD ST",
"city": "CANTON",
"state": "MA",
"postal_code": "020212303",
"telephone_number": "781-828-3533",
"fax_number": "781-828-2471"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "105 ERDMAN WAY",
"city": "LEOMINSTER",
"state": "MA",
"postal_code": "014531805",
"telephone_number": "978-537-7552",
"fax_number": "978-537-7383"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DIVITO",
"first_name": "BELDEN",
"middle_name": "LOUIS",
"credential": "P.A.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-06-11",
"last_updated": "2012-05-31",
"status": "A"
},
"taxonomies": [
{
"code": "363AS0400X",
"taxonomy_group": "",
"desc": "Physician Assistant, Surgical",
"state": "MA",
"license": "216",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Leominster, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 31, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.