Individual provider Active NPI

Amy E. Heiderich, MD

  • Pediatrics Physician
  • Boston, MA
National Provider Identifier
1992048730
Registry record updated Apr 17, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
281182 Issued in MA
Practice address
850 Harrison Ave # Yacc4
Boston, MA 02118-4001
Phone
(617) 414-4359
NPI assigned
Mar 29, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 17, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 281182 MA Primary

Addresses

Primary practice location

850 Harrison Ave # Yacc4
Boston, MA 02118-4001

Mailing address

BMC Provider Enrollment Office
960 Massachusetts Ave,.2ND Floor
Boston, MA 02119

Other names 1

  • Amy Dipilato Former name

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
I20200204002857 MA Practitioner - Pediatric Medicine 4284928870 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
281182MAMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Child Health Foundation of Boston, Inc. Pediatrics CurrentSince Jan 1, 2023 Accepting new patients
Boston Medical Center Corporation Current Accepting new patients

Locations

850 Harrison Ave
#4
Boston, MA 02118
Phone (617) 414-2000

Interoperability endpoints

  • Direct secure messaging: aheiderich29160@tuftsmedicine.direct-ci.com
  • Direct secure messaging: aheiderich178248@direct.bmc.masshiway.net

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1364515200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1713312000000",
    "number": "1992048730",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "BMC PROVIDER ENROLLMENT OFFICE",
            "address_2": "960 MASSACHUSETTS AVE,.2ND FLOOR",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "02119"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "850 HARRISON AVE # YACC4",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021184001",
            "telephone_number": "617-414-4359"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HEIDERICH",
        "first_name": "AMY",
        "middle_name": "E.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-03-29",
        "last_updated": "2024-04-17",
        "certification_date": "2024-04-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MA",
            "license": "281182",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "AMY",
            "last_name": "DIPILATO",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Boston, MA

Sources for this page

Verify at the official NPI Registry.