Samuel G Diedrich

Primary specialty

Behavior TechnicianTaxonomy code 106S00000X

Practice address

10 Gill St Ste J
Woburn, MA 01801-1721

Phone

(617) 505-6183

NPI assigned

Aug 21, 2020

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

Locations

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.

• Behavioral Concepts

  • Behavior Technician
  • Woburn, MA
  • NPI 1063008530
  NPD
• Abacs, LLC

  • Behavior Technician
  • Woburn, MA
  • NPI 1720515711
  NPD (past)

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

{
    "created_epoch": "1597968000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1597968000000",
    "number": "1831701614",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "89 CHAMPNEY ST",
            "city": "GROTON",
            "state": "MA",
            "postal_code": "014501358",
            "telephone_number": "978-877-9789"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 GILL ST STE J",
            "city": "WOBURN",
            "state": "MA",
            "postal_code": "018011721",
            "telephone_number": "617-505-6183"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIEDRICH",
        "first_name": "SAMUEL",
        "middle_name": "G",
        "name_prefix": "Mr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-08-21",
        "last_updated": "2020-08-21",
        "certification_date": "2020-08-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rebecca Lynn Diamantopoulos, PTA
• Alice Margaret Dicenzo, RN
• Amber Raelynn Dichiara
• Andrea Dicicco, PNP
• Catherine Jane Dickenson
• Kelly R. Dietel, MA
• Marissa Kathleen Digilio
• Digitrace Care Services, Inc.
• Diligent Personal Care, Inc
• Luke Dilillo

• Behavior Technician in Woburn, MA
• Providers in Woburn, MA by specialty
• Behavior Technician in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 21, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.