Individual provider Active NPI

Stephen Matthew Dimaggio, MD, PHARMD, RPH

  • Student in an Organized Health Care Education/Training Program
  • Memphis, TN
National Provider Identifier
1851994651
Registry record updated Apr 14, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
Practice address
920 Madison Ave Ste 447
Memphis, TN 38103-3438
Phone
(901) 448-5814
NPI assigned
Nov 16, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 14, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 28RI03887100 NJ
Student in an Organized Health Care Education/Training Program 390200000X Primary

Addresses

Primary practice location

920 Madison Ave Ste 447
Memphis, TN 38103-3438

Mailing address

920 Madison Ave
Memphis, TN 38103-3438
Phone (901) 448-3714

Other practice location 1

55 US Highway 9
Manalapan, NJ 07726-3018
Phone (732) 294-5197

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address RX16542@cvshealth.com

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250624003271 NJ Order and Referring Only - Internal MedicinePractitioner - Internal Medicine 4880106954

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine, Doctor of Pharmacy, Registered Pharmacist

State licenses

LicenseStateTypeSpecialty
28RI03887100NJMDPharmacist

Interoperability endpoints

  • Direct secure messaging: rx16542@cvshealth.com

NPI Registry JSON

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

{
    "created_epoch": "1605484800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744588800000",
    "number": "1851994651",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "920 MADISON AVE",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381033438",
            "telephone_number": "901-448-3714"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "920 MADISON AVE STE 447",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381033438",
            "telephone_number": "901-448-5814"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "55 US Highway 9",
            "address_purpose": "LOCATION",
            "city": "Manalapan",
            "state": "NJ",
            "postal_code": "077263018",
            "country_code": "US",
            "telephone_number": "732-294-5197",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DIMAGGIO",
        "first_name": "STEPHEN",
        "middle_name": "MATTHEW",
        "name_prefix": "Dr.",
        "credential": "MD, PHARMD, RPH",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-11-16",
        "last_updated": "2025-04-14",
        "certification_date": "2025-04-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NJ",
            "license": "28RI03887100",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "RX16542@cvshealth.com",
            "affiliation": "N",
            "endpointDescription": "direct pharmacy email",
            "address_1": "55 US Highway 9",
            "city": "Manalapan",
            "state": "NJ",
            "country_code": "US",
            "postal_code": "077263018",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Memphis, TN

Sources for this page

Verify at the official NPI Registry.