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DIMIRA E TAMBUNAN
NPI 1790245827
Psychiatry & Neurology - Neurology with Special Qualifications in Child Neurology in Boston, MA

Active since March 24, 2019PECOS Enrolled
300 LONGWOOD AVE, BOSTON, MA 02115(617) 355-6000 Get Directions Write a Review

NPPES record last updated: July 9, 2026. Verified against the NPPES registry weekly; last sync: October 04, 2026.

Record update history: Jul 9, 2026, Mar 24, 2019 (2 updates tracked since 2019).

About Dimira E Tambunan NPPES

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

DIMIRA E TAMBUNAN (NPI 1790245827) is an individual neurology with special qualifications in child neurology provider in Boston, Massachusetts, licensed in Massachusetts (1020730) and active in the NPI registry since March 2019. She is enrolled in Medicare PECOS and is a graduate of Other (2019).

NPPES Registry Identity

NPI1790245827
Entity TypeIndividualFemale
Primary Taxonomy2084N0402X
Provider Legal NameDIMIRA E TAMBUNAN
Location Address300 LONGWOOD AVEBoston, MA 02115-5724
Mailing Address300 Longwood AveBoston, MA 02115-5724 · (617) 355-6000
Phone(617) 355-6000
Sole ProprietorNo
Medical School CMSOtherGraduated 2019
Enumeration DateMarch 24, 2019
Last NPPES UpdateJuly 9, 20262 updates tracked since enumeration
NPPES CertifiedJuly 9, 2026
✔ NPI 1790245827 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPsychiatry & Neurology · Neurology with Special Qualifications in Child NeurologyAllopathic & Osteopathic Physicians
Taxonomy Code2084N0402X
License✔ Licensed in MA · 1020730
Definition
A Child Neurologist specializes in neurology with special skills in diagnosis and treatment of neurologic disorders of the neonatal period, infancy, early childhood, and adolescence.
300 LONGWOOD AVE, Boston, MA 02115
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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 (PECOS)

Dimira E Tambunan is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID1355806423
PECOS Enrollment IDI20260720000829
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 02115 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
$144.11 typical visit price
range $63.72 – $189.86
Typical copayment $36.02 (range $15.93 – $47.46)
Most-billed visit code 99204
Established Patient
$111.18 typical visit price
range $21.07 – $155.29
Typical copayment $27.79 (range $5.26 – $38.82)
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 20

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

JULIE ANN HANSEN LCSW
Social Worker (Clinical)
300 LONGWOOD AVE
BOSTON, MA 02115
Suffolk County (857) 218-4309
MS. ANNA ROGLIERI
Nurse Practitioner (Psychiatric/Mental Health)
300 LONGWOOD AVE
BOSTON, MA 02115
Suffolk County (617) 355-6000
STEPHEN G. FLYNN M.D.
Anesthesiology (Pediatric Anesthesiology)
300 LONGWOOD AVE
BOSTON, MA 02115
Suffolk County (617) 355-6000
MRS. LAUREN ASHLEY SHARIS P.T., D.P.T
Physical Therapist
300 LONGWOOD AVE
BOSTON, MA 02115
Suffolk County (617) 355-7216
MS. SOYUN KWAN LICSW
Social Worker (Clinical)
300 LONGWOOD AVE, CHILDREN'S HOSPITAL BOSTON
BOSTON, MA 02115
Suffolk County (617) 355-0567
PUJA BANKA M.D.
Pediatrics
300 LONGWOOD AVE, BADER 203
BOSTON, MA 02115
Suffolk County (617) 355-6363
MR. COURTNEY SULLIVAN FRATTO CPNP
Nurse Practitioner (Pediatrics)
300 LONGWOOD AVE, HUNNEWELL BUILDING 322
BOSTON, MA 02115
Suffolk County (857) 218-4085
DR. ELIZABETH S TAGLAUER M.D., PH.D.
Pediatrics (Neonatal-Perinatal Medicine)
300 LONGWOOD AVE
BOSTON, MA 02115
Suffolk County (617) 355-6000

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Dimira Tambunan's NPI number?

The NPI number for Dimira Tambunan is 1790245827. It was assigned to this individual provider in the NPPES registry on March 24, 2019.

Where is Dimira Tambunan located?

Dimira Tambunan practices at 300 Longwood Ave, Boston, MA 02115. The listed phone number is (617) 355-6000.

What is Dimira Tambunan's specialty?

The primary specialty registered for this NPI is Psychiatry & Neurology, specializing in Neurology with Special Qualifications in Child Neurology, with taxonomy code 2084N0402X.

Is Dimira Tambunan enrolled in Medicare?

Yes. Dimira Tambunan is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Dimira Tambunan was last updated on July 9, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.