Active NPI
Diane Kristina Witmer, LCSW
- Clinical Social Worker
- East Islip, NY
National Provider Identifier
1033771225
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 7058
- Practice address
- 56 Marilynn St
East Islip, NY 11730-2703 - Phone
- (631) 338-3913
- NPI assigned
- Jul 8, 2019
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 088174 | NY | |
| Clinical Social Worker | 1041C0700X | 0904011127 | VA | |
| Clinical Social Worker | 1041C0700X | 7058 | TN | Primary |
Addresses
Primary practice location
56 Marilynn St
East Islip, NY 11730-2703
Mailing address
56 Marilynn St
East Islip, NY 11730-2703
Phone (631) 338-3913
Electronic endpoints 2
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | dwitmer@northwell.edu | Direct | |
| Direct Messaging Address | dwitmer@northwell.edu | Health Information Exchange (HIE) |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TN
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Clinical Social Worker
- Education
- Other, 2010
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
482 Interstate Dr
Manchester, TN 37355-3109
Phone (931) 728-4718
606 N Broad St
New Tazewell, TN 37825-6610
Phone (423) 259-5002
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0904011127 | VA | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Elite Urgent Care PLLC | Current | Accepting new patients | |
| Ultacare Medical PLLC | Clinical | Current | Accepting new patients |
Locations
1225 E Weisgarber Rd
Ste 190
Knoxville, TN 37909
Phone (423) 259-5002
606 N Broad St
New Tazewell, TN 37825
Phone (423) 626-0466
5261 Carrollton Pike
Ste A
Woodlawn, VA 24381
5261 Carrollton Pike
Ste C
Woodlawn, VA 24381
Phone (276) 238-0911
Organizations & group practices 4
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.
-
- Family Medicine Physician
- New Tazewell, TN
- NPI 1447803390
-
- Rural Health Clinic/Center
- Manchester, TN
- NPI 1700192028
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1562544000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1701043200000",
"number": "1033771225",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "56 MARILYNN ST",
"city": "EAST ISLIP",
"state": "NY",
"postal_code": "117302703",
"telephone_number": "631-338-3913"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "56 MARILYNN ST",
"city": "EAST ISLIP",
"state": "NY",
"postal_code": "117302703",
"telephone_number": "631-338-3913"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WITMER",
"first_name": "DIANE",
"middle_name": "KRISTINA",
"credential": "LCSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2019-07-08",
"last_updated": "2023-11-27",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "NY",
"license": "088174",
"primary": false
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "VA",
"license": "0904011127",
"primary": false
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "TN",
"license": "7058",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "dwitmer@northwell.edu",
"affiliation": "Y",
"endpointDescription": "dwitmer@northwell.edu",
"use": "DIRECT",
"useDescription": "Direct",
"contentType": "CSV",
"contentTypeDescription": "CSV",
"address_1": "888 Old Country Rd",
"city": "Plainview",
"state": "NY",
"country_code": "US",
"postal_code": "118034914",
"country_name": "United States",
"address_type": "DOM"
},
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "dwitmer@northwell.edu",
"affiliation": "Y",
"endpointDescription": "email address",
"use": "HIE",
"useDescription": "Health Information Exchange (HIE)",
"contentType": "CSV",
"contentTypeDescription": "CSV",
"address_1": "888 Old Country Rd",
"city": "Plainview",
"state": "NY",
"country_code": "US",
"postal_code": "118034914",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in East Islip, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 27, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.