Active NPI
Patricia Anne Dykstra, MD
- Pediatrics Physician
- Lowell, MA
National Provider Identifier
1851365035
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- 77409
- Practice address
- 597 Merrimack St
Lowell Community Health Center
Lowell, MA 01854 - Phone
- (978) 937-9700
- Fax
- (978) 446-9830
- NPI assigned
- Feb 15, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 77409 | MA | Primary |
| Pediatric Infectious Diseases Physician | 2080P0208X | 77409 | MA |
Addresses
Primary practice location
597 Merrimack St
Lowell Community Health Center
Lowell, MA 01854
Mailing address
597 Merrimack St
Lowell Community Health Center
Lowell, MA 01854
Phone (978) 937-9700
Other identifiers 13
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 042881348 | Other | BEECH STREET | |
| 1339 | Other | NEIGHBORHOOD HEALTH PLAN | |
| 6469876 | Other | CIGNA | |
| 204699 | Other | HARVARD PILGRIM HLTH CARE | |
| 9204204 | Other | UNITED HEALTH CARE | |
| 731688 | Other | TUFTS | |
| J14028 | Other | BLUE CROSS BLUE SHIELD | |
| 22397 | Other | FALLON | |
| 979892 | Other | NETWORK HEALTH | |
| 3437455 | Other | AETNA | |
| 042881348 | Other | ONE HEALTH | |
| 1305557 | Medicaid | MA | |
| 042881348 | Other | CHOICECARE |
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
- Doctor of Medicine
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1139961600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1217376000000",
"number": "1851365035",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "597 MERRIMACK ST",
"address_2": "LOWELL COMMUNITY HEALTH CENTER",
"city": "LOWELL",
"state": "MA",
"postal_code": "01854",
"telephone_number": "978-937-9700",
"fax_number": "978-446-9830"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "597 MERRIMACK ST",
"address_2": "LOWELL COMMUNITY HEALTH CENTER",
"city": "LOWELL",
"state": "MA",
"postal_code": "01854",
"telephone_number": "978-937-9700",
"fax_number": "978-446-9830"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DYKSTRA",
"first_name": "PATRICIA",
"middle_name": "ANNE",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-02-15",
"last_updated": "2008-07-30",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "MA",
"license": "77409",
"primary": true
},
{
"code": "2080P0208X",
"taxonomy_group": "",
"desc": "Pediatrics, Pediatric Infectious Diseases",
"state": "MA",
"license": "77409",
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BEECH STREET",
"identifier": "042881348",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NEIGHBORHOOD HEALTH PLAN",
"identifier": "1339",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CIGNA",
"identifier": "6469876",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HARVARD PILGRIM HLTH CARE",
"identifier": "204699",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UNITED HEALTH CARE",
"identifier": "9204204",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TUFTS",
"identifier": "731688",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD",
"identifier": "J14028",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "FALLON",
"identifier": "22397",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NETWORK HEALTH",
"identifier": "979892",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA",
"identifier": "3437455",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ONE HEALTH",
"identifier": "042881348",
"state": null
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1305557",
"state": "MA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CHOICECARE",
"identifier": "042881348",
"state": null
}
],
"endpoints": [],
"other_names": []
}Other providers in Lowell, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 30, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.