Individual provider Active NPI

Dianne Macleod

  • Adult Health Nurse Practitioner
  • North Andover, MA
National Provider Identifier
1831567767
Registry record updated Sep 9, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
RN217520 Issued in MA
Practice address
120 Water St
North Andover, MA 01845-2648
Phone
(978) 685-2460
NPI assigned
Sep 9, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 9, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X RN217520 MA Primary

Addresses

Primary practice location

120 Water St
North Andover, MA 01845-2648

Mailing address

4 Ellen Rd
Woburn, MA 01801-2210
Phone (339) 227-0573

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20151123000479 MA Practitioner - Nurse Practitioner 1052611191 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Maya Berdzenishvili MD LLC CurrentSince Oct 28, 2024 Accepting new patients

Locations

95 Commercial St
Braintree, MA 02184
Phone (781) 848-0596

120 Main St
Malden, MA 02148
Phone (781) 322-3005

11 North St
Stoneham, MA 02180
Phone (603) 759-4559

25 Woodland Rd
Stoneham, MA 02180
Phone (781) 438-7775

Organizations & group practices 1

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": "1441756800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1441756800000",
    "number": "1831567767",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4 ELLEN RD",
            "city": "WOBURN",
            "state": "MA",
            "postal_code": "018012210",
            "telephone_number": "339-227-0573"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 WATER ST",
            "city": "NORTH ANDOVER",
            "state": "MA",
            "postal_code": "018452648",
            "telephone_number": "978-685-2460"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MACLEOD",
        "first_name": "DIANNE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-09-09",
        "last_updated": "2015-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "MA",
            "license": "RN217520",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in North Andover, MA

Sources for this page

Verify at the official NPI Registry.