Individual provider Active NPI

Dana Marcinkowski-Desmond, M.D.

  • Family Medicine Physician
  • Medford, MA
National Provider Identifier
1922454677
Registry record updated Jul 29, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
277849 Issued in MA
Practice address
75 Riverside Ave Ste 2
Medford, MA 02155-4600
Phone
(781) 306-0200
NPI assigned
May 12, 2016
Sex
Female
Sole proprietor
No

Organizations & group practices 5

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.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Tufts University School of Medicine, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Beth Israel Lahey Health Primary Care, Inc 351 clinicians

Practice addresses (Care Compare)

15 Railroad Ave
South Hamilton, MA 01982-2218
Phone (978) 468-7381

Hospital & facility affiliations

  • Winchester Hospital Hospital, Winchester, MA, CCN 220105
  • Beth Israel Deaconess Medical Center Hospital, Boston, MA, CCN 220086
  • Lahey Hospital & Medical Center, Burlington Hospital, Burlington, MA, CCN 220171

Merit-based Incentive Payment System (MIPS)

Final score
91.98 of 100Reported as apm
Quality
76.59
Promoting interoperability
100
Improvement activities
40

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
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
I20191115001127 MA Practitioner - Family Practice 3779874656 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Beth Israel Lahey Health Primary Care, Inc. CurrentSince Dec 1, 2024 Accepting new patients
Winchester Physician Associates, Inc Family Medicine CurrentSince Oct 13, 2019 Accepting new patients
Beth Israel Lahey Health Primary Care Inc CurrentSince Dec 1, 2024 Accepting new patients
Winchester Physician Associates Past Accepting new patients
Beth Israel Lahey Health Primary Care, Inc. Past Accepting new patients

Locations

41 Mall Rd
Burlington, MA 01805
Phone (781) 744-8400

101 Station Lndg
Ste 500
Medford, MA 02155
Phone (781) 306-0200

75 Riverside Ave
Ste 2
Medford, MA 02155
Phone (781) 306-0200

203 Main St
North Reading, MA 01864
Phone (978) 664-1990

15 Railroad Ave
South Hamilton, MA 01982
Phone (978) 468-7381

Interoperability endpoints

  • Direct secure messaging: dmarcinkowskidesmond108446@direct.bilh.masshiway.net
  • FHIR API: https://api.platform.athenahealth.com/10729/brand/1/csg/1/fhir/r4

Specialties & licenses 1

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 277849 MA Primary

Addresses

NPPES NPI Registry

Primary practice location

75 Riverside Ave Ste 2
Medford, MA 02155-4600

Mailing address

75 Riverside Ave Ste 2
Medford, MA 02155-4600

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jul 29, 2019.

{
    "created_epoch": "1463011200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1564358400000",
    "number": "1922454677",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "75 RIVERSIDE AVE STE 2",
            "city": "MEDFORD",
            "state": "MA",
            "postal_code": "021554600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "75 RIVERSIDE AVE STE 2",
            "city": "MEDFORD",
            "state": "MA",
            "postal_code": "021554600",
            "telephone_number": "781-306-0200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARCINKOWSKI-DESMOND",
        "first_name": "DANA",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-05-12",
        "last_updated": "2019-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MA",
            "license": "277849",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Medford, MA

Sources for this page

Verify at the official NPI Registry.