DIMITRA MAMMOS DNP, FNP-BC
NPI 1194544379
Nurse Practitioner - Family in Bristow, VA

Q: What is Dimitra Mammos's NPI number?

The NPI number for Dimitra Mammos is 1194544379. It was assigned to this individual provider in the NPPES registry on October 7, 2024.

Q: What is Dimitra Mammos's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

Q: When was this NPI record last updated?

The NPPES record for Dimitra Mammos was last updated on July 29, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since October 07, 2024PECOS EnrolledAccepts Medicare Assignment

10322 BRISTOW CENTER DR, BRISTOW, VA 20136(571) 284-4245 Get Directions Write a Review

NPPES record last updated: July 29, 2025. Verified against the NPPES registry weekly; last sync: August 02, 2026.

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About Dimitra Mammos Dnp, Fnp-bc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DIMITRA MAMMOS DNP, FNP-BC (NPI 1194544379) is an individual family provider in Bristow, Virginia, licensed in Virginia (0024190799) and active in the NPI registry since October 2024. She is enrolled in Medicare PECOS and is a graduate of Other (2024).

NPPES Registry Identity

NPI1194544379

Entity TypeIndividualFemale

Primary Taxonomy363LF0000X

Provider Legal NameDIMITRA MAMMOSCredential: DNP, FNP-BC

Location Address10322 BRISTOW CENTER DRBristow, VA 20136-2201

Mailing AddressPo Box 748613Atlanta, GA 30374-8613

Phone(571) 284-4245

Sole ProprietorNo

Medical School CMSOtherGraduated 2024

Enumeration DateOctober 7, 2024

Last NPPES UpdateJuly 29, 2025

NPPES CertifiedJuly 29, 2025

✔ NPI 1194544379 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363LF0000X

License✔ Licensed in VA · 0024190799

10322 BRISTOW CENTER DR, Bristow, VA 20136

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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Dimitra Mammos Dnp, Fnp-bc is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID5193251098

PECOS Enrollment IDI20250608000039

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 20136 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$86.88 typical visit price

range $56.19 – $170.30

Typical copayment $21.72 (range $14.04 – $42.57)

Most-billed visit code 99203

Established Patient

$99.13 typical visit price

range $18.07 – $138.91

Typical copayment $24.78 (range $4.51 – $34.72)

Most-billed visit code 99214

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 13

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

REBECCA A REHMANN D.O.

Family Medicine