Organization Active NPI

Kristen R. Dimarco, DO LTD

  • Family Medicine Physician
  • Warwick, RI
National Provider Identifier
1962542829
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
00503 Issued in RI
Legal business name
KRISTEN R. DIMARCO, DO LTD
Practice address
215 Toll Gate Rd
Suite 306
Warwick, RI 02886-4458
Phone
(401) 738-6565
Fax
(401) 738-6599
NPI assigned
Feb 8, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Michael Richard Martin, DONPI 1376607168
Title
Vice President
Phone
(401) 738-6565

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
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X 00503 RI Primary

Addresses

Primary practice location

215 Toll Gate Rd
Suite 306
Warwick, RI 02886-4458

Mailing address

215 Toll Gate Rd
Suite 306
Warwick, RI 02886-4458
Phone (401) 738-6565

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in RI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20101215000096 RI Part B Supplier - Clinic/Group Practice 2668669789 Receives reassigned benefits from 2 practitioners
Practice locations: Warwick, RI

National Provider Directory

National Provider Directory

Locations

215 Toll Gate Rd
Ste 306
Warwick, RI 02886
Phone (401) 373-0820

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1170892800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1962542829",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "215 TOLL GATE RD",
            "address_2": "SUITE 306",
            "city": "WARWICK",
            "state": "RI",
            "postal_code": "028864458",
            "telephone_number": "401-738-6565",
            "fax_number": "401-738-6599"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "215 TOLL GATE RD",
            "address_2": "SUITE 306",
            "city": "WARWICK",
            "state": "RI",
            "postal_code": "028864458",
            "telephone_number": "401-738-6565",
            "fax_number": "401-738-6599"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KRISTEN R. DIMARCO, DO LTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-08",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MARTIN",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "RICHARD",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "401-738-6565",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "RI",
            "license": "00503",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Warwick, RI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.