NPIMap

Individual provider Active NPI

Thomas Leo Diana, PH.D.

  • Health Service Psychologist
  • Winona, MN
National Provider Identifier
1093874281
Registry record updated Jan 22, 2010
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Key facts

NPPES NPI Registry
Primary specialty
Health Service PsychologistTaxonomy code 103TH0100X
License
LP1219 Issued in MN
Practice address
66 E 3Rd St
Winona, MN 55987-3478
Phone
(507) 452-1021
Fax
(507) 452-1504
NPI assigned
Dec 6, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 22, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Health Service Psychologist 103TH0100X LP1219 MN Primary

Addresses

Primary practice location

66 E 3Rd St
Winona, MN 55987-3478

Mailing address

66 E 3Rd St
Winona, MN 55987-3478
Phone (507) 452-1021

Other identifiers 5

IdentifierTypeStateIssuer
731291041000OtherMNPREFERRED ONE
126921OtherMNUCARE
200048200MedicaidMN
78G63DIOtherMNBCBS-MN
HP41036OtherMNHEALTHPARTNERS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
LP1219MNMDHealth Service Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Family Service of Winona Past Accepting new patients
Family & Children's Center, Inc. Past Accepting new patients
Home and Community Options, Inc. Past Accepting new patients

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1165363200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1264118400000",
    "number": "1093874281",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "66 E 3RD ST",
            "city": "WINONA",
            "state": "MN",
            "postal_code": "559873478",
            "telephone_number": "507-452-1021",
            "fax_number": "507-452-1504"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "66 E 3RD ST",
            "city": "WINONA",
            "state": "MN",
            "postal_code": "559873478",
            "telephone_number": "507-452-1021",
            "fax_number": "507-452-1504"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIANA",
        "first_name": "THOMAS",
        "middle_name": "LEO",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-06",
        "last_updated": "2010-01-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TH0100X",
            "taxonomy_group": "",
            "desc": "Psychologist, Health Service",
            "state": "MN",
            "license": "LP1219",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PREFERRED ONE",
            "identifier": "731291041000",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UCARE",
            "identifier": "126921",
            "state": "MN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200048200",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS-MN",
            "identifier": "78G63DI",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHPARTNERS",
            "identifier": "HP41036",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Winona, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.