John Louis Diakun, MS

Key facts

NPI

1154475655

Entity type

Individual (NPI type 1)

Primary specialty

Audiologist 231H00000X

License

000075 (CT)

Practice address

211 New Britain Rd
Suite #108
Kensington, CT 06037-1360

Phone

(860) 826-6450

Fax

(860) 826-6451

NPI assigned

Jan 22, 2007

Sex

Male

Sole proprietor

Yes

Organizations & group practices 2

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.

• John Louis Diakun Audiologist-Hearing Aid Fitter · Kensington, CT · NPI 1548510787
  NPD (past) Authorized official
• Hartford Healthcare at Home, Inc Community Based Hospice Care Agency · Wethersfield, CT · NPI 1548283674
  NPD (past)

Medicare participation

Medicare fee-for-service enrollment

Enrolled in CT

Medicare enrollment records

National Provider Directory

Medicare enrollment (NPD)

Yes

Credentials

Master of Science

State licenses

Practice roles

Specialties & licenses

Addresses

Other identifiers

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Aug 5, 2020.

{
    "created_epoch": "1169424000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1596585600000",
    "number": "1154475655",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "211 NEW BRITAIN RD",
            "address_2": "SUITE #108",
            "city": "KENSINGTON",
            "state": "CT",
            "postal_code": "060371360",
            "telephone_number": "860-826-6450",
            "fax_number": "860-826-6451"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "211 NEW BRITAIN RD",
            "address_2": "SUITE #108",
            "city": "KENSINGTON",
            "state": "CT",
            "postal_code": "060371360",
            "telephone_number": "860-826-6450",
            "fax_number": "860-826-6451"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIAKUN",
        "first_name": "JOHN",
        "middle_name": "LOUIS",
        "name_prefix": "Mr.",
        "credential": "MS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-22",
        "last_updated": "2020-08-05",
        "certification_date": "2020-08-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "237700000X",
            "taxonomy_group": "",
            "desc": "Hearing Instrument Specialist",
            "state": "CT",
            "license": "000103",
            "primary": false
        },
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "CT",
            "license": "000075",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004015038",
            "state": "CT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004035143",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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All providers in Kensington, CT · Audiologist in Connecticut