Dima Ezzedine, M.D.

Primary specialty

Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X

License

264000 Issued in MA

Practice address

45 Home Depot Dr Ste 100
Plymouth, MA 02360-2669

Phone

(781) 762-0471

Fax

(973) 290-7520

NPI assigned

Jun 22, 2015

Sex

Female

Sole proprietor

Yes

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

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

Specialty

Obstetrics/Gynecology

Education

Other, 2010

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Greater Boston Urology LLCGroup PAC ID 1153516513, 44 clinicians

Pratt OB/GYN Associates, IncGroup PAC ID 9638060254, 60 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Tufts Medical Center Hospital, Boston, MA, CCN 220116
• Melrosewakefield Healthcare Hospital, Melrose, MA, CCN 220070
• Spaulding Rehabilitation Hospital - Cape Cod Inpatient rehabilitation facility, East Sandwich, MA, CCN 223032

Merit-based Incentive Payment System (MIPS)

Final score

100 of 100Reported as group

Promoting interoperability

100

Improvement activities

40

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: dezzedine255342@direct.bilh.masshiway.net
• Direct secure messaging: dimaezzedine@gbu.medalliesdirect.net
• Direct secure messaging: dezzedine147931@tuftsmedicine.direct-ci.com

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.

• Pratt OB/GYN Associates, Inc

  • Obstetrics & Gynecology Physician
  • Boston, MA
  • NPI 1336186501
  Medicare reassignment Care Compare group NPD
• Greater Boston Urology, LLC

  • Urology Physician
  • Dedham, MA
  • NPI 1003120411
  Medicare reassignment Care Compare group
• Brockton Urology Clinic Inc

  • Urology Physician
  • North Easton, MA
  • NPI 1336147438
  NPD
• Gbu Bidco LLC

  • Urology Physician
  • Framingham, MA
  • NPI 1972051977
  NPD
• Gbu Steward LLC

  • Urology Physician
  • North Easton, MA
  • NPI 1275064909
  NPD (past)
• Practice Associates Medical Group

  • Internal Medicine Physician
  • Morristown, NJ
  • NPI 1427016385

  Obstetrics & Gynecology

  NPD (past)

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

• Melrosewakefield Healthcare, Inc.

  • General Acute Care Hospital
  • Medford, MA
  • NPI 1841290467
  Care Compare affiliation
• Rehabilitation Hospital of the Cape and Islands, Corporation

  • Rehabilitation Hospital
  • E Sandwich, MA
  • NPI 1265489736

  Inpatient rehabilitation facility

  Care Compare affiliation
• Tufts Medical Center, Inc.

  • General Acute Care Hospital
  • Boston, MA
  • NPI 1730132515
  Care Compare affiliation

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

{
    "created_epoch": "1434931200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1675814400000",
    "number": "1922480391",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "115 LINCOLN ST",
            "city": "FRAMINGHAM",
            "state": "MA",
            "postal_code": "017026358",
            "telephone_number": "508-383-1000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "45 HOME DEPOT DR STE 100",
            "city": "PLYMOUTH",
            "state": "MA",
            "postal_code": "023602669",
            "telephone_number": "781-762-0471",
            "fax_number": "973-290-7520"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EZZEDINE",
        "first_name": "DIMA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-06-22",
        "last_updated": "2023-02-08",
        "certification_date": "2023-02-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "MA",
            "license": "264000",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Danielle Everett
• Katherine Christina Evitts
• Juliana Exume
• Eye Health Services,Inc.
• Hillary C Ezrin, MS, LRC, CRC
• Diane D Fafard
• Doreen Fagerberg, LCSW
• Brian M Faghan, PTA
• Ann Marie Savignano Fahey
• Scott Fairfield, M.D.

• Obstetrics & Gynecology Physician in Plymouth, MA
• Providers in Plymouth, MA by specialty
• Obstetrics & Gynecology Physician in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 8, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.