NPIMap

Organization Active NPI

Nimvax, Inc

Doing business as Nimvax

  • Pharmacy
  • Beverly, MA
National Provider Identifier
1952076911
Registry record updated Feb 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacyTaxonomy code 333600000X
Legal business name
NIMVAX, INC
Doing business as
Nimvax
NimMed
Practice address
600 Cummings Ctr Ste 165Z
Beverly, MA 01915-6165
Phone
(781) 632-1920
NPI assigned
Aug 12, 2021
Last updated
Feb 11, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 11, 2025

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

Authorized official

Name
Dr. Nimit Deocampo, PHARMDNPI 1477130987
Title
Ceo
Phone
(617) 819-2980

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X NU Primary

Addresses

Primary practice location

600 Cummings Ctr Ste 165Z
Beverly, MA 01915-6165

Mailing address

1100 Salem St Apt 90
Lynnfield, MA 01940-1584

Other names 2

  • NIMVAX Doing business as
  • NimMed Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20210913001055 MA Part B Supplier - Mass Immunization (Roster Biller Only) 2961808241 Practice locations: Beverly, MA
O20250211001406 MA Part B Supplier - Pharmacy 2961808241 Practice locations: Beverly, MA

National Provider Directory

National Provider Directory
Tax ID family
Nimltc2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1628726400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1739232000000",
    "number": "1952076911",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1100 SALEM ST APT 90",
            "city": "LYNNFIELD",
            "state": "MA",
            "postal_code": "019401584"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 CUMMINGS CTR STE 165Z",
            "city": "BEVERLY",
            "state": "MA",
            "postal_code": "019156165",
            "telephone_number": "781-632-1920"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NIMVAX, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-08-12",
        "last_updated": "2025-02-11",
        "certification_date": "2025-02-11",
        "status": "A",
        "authorized_official_last_name": "DEOCAMPO",
        "authorized_official_first_name": "NIMIT",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "617-819-2980",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHARMD"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "NIMVAX",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "NimMed",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Beverly, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.