Individual provider Active NPI

Diana Marie Stephens, MD

  • Dermatology Physician
  • Ithaca, NY
National Provider Identifier
1154687945
Registry record updated Oct 6, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
294045 Issued in NY
Practice address
1020 Craft Rd Ste a
Ithaca, NY 14850-1016
Phone
(607) 339-0456
NPI assigned
Apr 5, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 6, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X 294045 NY Primary

Addresses

Primary practice location

1020 Craft Rd Ste a
Ithaca, NY 14850-1016

Mailing address

1020 Craft Rd Ste a
Ithaca, NY 14850-1016
Phone (607) 339-0456

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20180723001927 NY Practitioner - Dermatology 9436406444 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Dermatology
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Geneva General Hospital, IncGroup PAC ID 7810809407, 88 clinicians

Practice addresses (Care Compare)

70 Mason St
Geneva, NY 14456-1104
Phone (315) 787-5355

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as group

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision1-10
Removal of skin lesions869
Removal or shaving of skin growth1-10
Skin biopsy262

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Geneva General Hospital Inc Dermatology CurrentSince Jul 1, 2023 Accepting new patients
Geneva General Hospital, Inc CurrentSince Jul 1, 2023 Accepting new patients
Geneva General Hospital, Inc Current Accepting new patients
Geneva General Hospital Inc. Past Accepting new patients

Locations

70 Mason St
Geneva, NY 14456
Phone (315) 787-5355

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.

Hospital & facility affiliations 7

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": "1333584000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1538784000000",
    "number": "1154687945",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1020 CRAFT RD STE A",
            "city": "ITHACA",
            "state": "NY",
            "postal_code": "148501016",
            "telephone_number": "607-339-0456"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1020 CRAFT RD STE A",
            "city": "ITHACA",
            "state": "NY",
            "postal_code": "148501016",
            "telephone_number": "607-339-0456"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STEPHENS",
        "first_name": "DIANA",
        "middle_name": "MARIE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-04-05",
        "last_updated": "2018-10-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "NY",
            "license": "294045",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ithaca, NY

Sources for this page

Verify at the official NPI Registry.