Individual provider Active NPI

Diana V Marin, M.D.

  • Pediatric Radiology Physician
  • New York, NY
National Provider Identifier
1093701161
Registry record updated Dec 28, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Radiology PhysicianTaxonomy code 2085P0229X
License
286807 Issued in NY
Practice address
622 W 168TH St
New York, NY 10032-3720
Phone
(973) 972-5188
Fax
(973) 972-2307
NPI assigned
Sep 23, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 28, 2023

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Radiology Physician 2085P0229X ME94558 FL
Pediatric Radiology Physician 2085P0229X 25MA10311000 NJ
Diagnostic Radiology Physician 2085R0202X 286807 NY
Pediatric Radiology Physician 2085P0229X 286807 NY Primary

Addresses

Primary practice location

622 W 168TH St
New York, NY 10032-3720

Mailing address

30 Bergen Street
Building 12 Room 1205
Newark, NJ 07107-3000
Phone (972) 972-0037

Other identifiers 3

IdentifierTypeStateIssuer
0062685MedicaidNJ
274212800MedicaidFL
286807OtherNYNYS MEDICAL LICENSE

Electronic endpoints 3

TypeEndpointUseAffiliation
FHIR URL https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/DSTU2/ Health Information Exchange (HIE)
FHIR URL https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/R4/ Health Information Exchange (HIE)
Direct Messaging Address tmi9003@direct.nyp.org Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20060120000130 FL Practitioner - Diagnostic RadiologyPractitioner - Pediatric Medicine 0042276818 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic RadiologyAlso: Pediatric Medicine
Education
Other, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Pediatric Physician Services, Inc.Group PAC ID 7113989849, 200 clinicians

Practice addresses (Care Compare)

601 5TH St S
Suite 5
St Petersburg, FL 33701-4804
Phone (727) 727-4429

Hospital & facility affiliations

  • Johns Hopkins All Children'S Hospital Hospital, Saint Petersburg, FL, CCN 103300

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as apm
Quality
85.32
Promoting interoperability
100
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as apm
Quality
85.32
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
286807NYMDPediatric Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Maimonides Medical Center - MMC Radiology FPP Diagnostic Radiology CurrentSince Feb 1, 2017 Accepting new patients
Columbia/Newyork-Presbyterian Advanced Imaging Inc. CurrentSince Nov 23, 2024 Accepting new patients
Pediatric Physician Services, Inc. CurrentSince Dec 19, 2024 Accepting new patients
Lawrence Medical Associates, PC CurrentSince Nov 28, 2023 Accepting new patients
Trustees of Columbia University in the City of New York Diagnostic Radiology CurrentSince Mar 25, 2022 Accepting new patients
Trustees of Columbia University in the City of New York CurrentSince Mar 25, 2022 Accepting new patients
The Nemours Foundation CurrentSince Sep 28, 2024 Accepting new patients
Columbiadoctors/Newyork-Presbyterianimaging CurrentSince Mar 25, 2022 Accepting new patients
Lawrence Medical Associates, PC CurrentSince Nov 28, 2023 Accepting new patients
The Nemours Foundation CurrentSince Sep 28, 2024 Accepting new patients
Radiology Imaging Associates, LLC Diagnostic Radiology CurrentSince Jan 1, 2026 Accepting new patients
The Nemours Foundation Current Accepting new patients
Trustees of Columbia University in the City of New York Past Accepting new patients
Radiology Associates of Children'S Hospital, Inc Pediatric Radiology Past Accepting new patients
Radiology Associates of Hollywood, Inc. Diagnostic Radiology Past Accepting new patients

Locations

577 N Williamson Blvd
Daytona Beach, FL 32114

807 Childrens Way
Jacksonville, FL 32207
Phone (904) 390-3600

1490 SE Magnolia Ext
Ocala, FL 34471
Phone (352) 512-9703

6535 Nemours Pkwy
Orlando, FL 32827
Phone (407) 567-4000

1041 Dunlawton Ave
Pt Orange, FL 32127
Phone (386) 322-4700

501 6th Ave S
St Petersburg, FL 33701
Phone (727) 344-6060

601 5th St S
Ste 5
St Petersburg, FL 33701
Phone (727) 727-4429

4802 10th Ave
Brooklyn, NY 11219
Phone (718) 283-8724

685 White Plains Rd
Lowr
Eastchester, NY 10709
Phone (914) 787-4100

685 White Plains Rd
Fl 2
Eastchester, NY 10709
Phone (914) 787-4100

1329 Boston Post Rd
Ste 1
Larchmont, NY 10538

1329 Boston Post Rd
Larchmont, NY 10538
Phone (914) 833-9121

161 Fort Washington Ave
New York, NY 10032
Phone (212) 305-8559

622 W 168th St
New York, NY 10032
Phone (212) 305-4931

722 W 168th St
New York, NY 10032
Phone (212) 305-6754

Networks

  • Optimum HealthCare HMO Network

Interoperability endpoints

  • Direct secure messaging: dmarin1245712@direct.hopkinsmedicine.org
  • Direct secure messaging: tmi9003@direct.nyp.org
  • FHIR API: https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/R4/
  • FHIR API: https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/DSTU2/

Organizations & group practices 17

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.

View all 17

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1127433600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1703721600000",
    "number": "1093701161",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30 BERGEN STREET",
            "address_2": "BUILDING 12 ROOM 1205",
            "city": "NEWARK",
            "state": "NJ",
            "postal_code": "071073000",
            "telephone_number": "972-972-0037",
            "fax_number": "973-972-0743"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "622 W 168TH ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100323720",
            "telephone_number": "973-972-5188",
            "fax_number": "973-972-2307"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARIN",
        "first_name": "DIANA",
        "middle_name": "V",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-09-23",
        "last_updated": "2023-12-28",
        "certification_date": "2023-12-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085P0229X",
            "taxonomy_group": "",
            "desc": "Radiology, Pediatric Radiology",
            "state": "FL",
            "license": "ME94558",
            "primary": false
        },
        {
            "code": "2085P0229X",
            "taxonomy_group": "",
            "desc": "Radiology, Pediatric Radiology",
            "state": "NJ",
            "license": "25MA10311000",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "NY",
            "license": "286807",
            "primary": false
        },
        {
            "code": "2085P0229X",
            "taxonomy_group": "",
            "desc": "Radiology, Pediatric Radiology",
            "state": "NY",
            "license": "286807",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0062685",
            "state": "NJ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "274212800",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NYS MEDICAL LICENSE",
            "identifier": "286807",
            "state": "NY"
        }
    ],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/DSTU2/",
            "affiliation": "N",
            "endpointDescription": "FHIR",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "FHIR",
            "address_1": "1329 Boston Post Rd Ste 1",
            "city": "Larchmont",
            "state": "NY",
            "country_code": "US",
            "postal_code": "105383902",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/R4/",
            "affiliation": "N",
            "endpointDescription": "FHIR",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "FHIR",
            "address_1": "1329 Boston Post Rd Ste 1",
            "city": "Larchmont",
            "state": "NY",
            "country_code": "US",
            "postal_code": "105383902",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "tmi9003@direct.nyp.org",
            "affiliation": "N",
            "endpointDescription": "Direct Address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Direct Address",
            "address_1": "1329 Boston Post Rd Ste 1",
            "city": "Larchmont",
            "state": "NY",
            "country_code": "US",
            "postal_code": "105383902",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.