Active NPI
Paul Nicholas Dimiero, OTR
- Pediatric Occupational Therapist
- Fairport, NY
National Provider Identifier
1861779415
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Occupational Therapist
- License
- 002238-1
- Practice address
- 28 S Village TRL
Fairport, NY 14450-4503 - Phone
- (585) 377-5016
- NPI assigned
- Nov 10, 2011
- 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 |
|---|---|---|---|---|
| Pediatric Occupational Therapist | 225XP0200X | 002238-1 | NY | Primary |
Addresses
Primary practice location
28 S Village TRL
Fairport, NY 14450-4503
Mailing address
28 S Village TRL
Fairport, NY 14450-4503
Phone (585) 377-5016
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 002238-1 | NY | MD | Pediatric Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1320883200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1320883200000",
"number": "1861779415",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "28 S VILLAGE TRL",
"city": "FAIRPORT",
"state": "NY",
"postal_code": "144504503",
"telephone_number": "585-377-5016"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "28 S VILLAGE TRL",
"city": "FAIRPORT",
"state": "NY",
"postal_code": "144504503",
"telephone_number": "585-377-5016"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DIMIERO",
"first_name": "PAUL",
"middle_name": "NICHOLAS",
"name_prefix": "Mr.",
"credential": "OTR",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2011-11-10",
"last_updated": "2011-11-10",
"status": "A"
},
"taxonomies": [
{
"code": "225XP0200X",
"taxonomy_group": "",
"desc": "Occupational Therapist, Pediatrics",
"state": "NY",
"license": "002238-1",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fairport, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 10, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.