Individual provider Active NPI

Diana Waxler, PA-C

  • Medical Physician Assistant
  • White Plains, NY
National Provider Identifier
1164622858
Registry record updated Jul 29, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
009985 Issued in NY
Practice address
210 Westchester Ave
White Plains, NY 10604-2901
Phone
(914) 681-3100
Fax
(914) 682-6588
NPI assigned
Jul 20, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 29, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 009985 NY Primary

Addresses

Primary practice location

210 Westchester Ave
White Plains, NY 10604-2901

Mailing address

800 Westchester Ave
Ste N715
Rye Brook, NY 10573-1369
Phone (914) 607-5730

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, CT2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20071103000009 NY Practitioner - Physician Assistant 7012004336 Reassigns benefits to 2 organizations
I20150827002034 CT Practitioner - Physician Assistant 7012004336 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Westchester Medical Group, P.CGroup PAC ID 6406752963, 410 clinicians

Practice addresses (Care Compare)

1 Theall Rd
Rye, NY 10580-1404
Phone (914) 848-8888

1084 N Broadway
Yonkers, NY 10701-1107
Phone (914) 848-8640

171 Huguenot St
New Rochelle, NY 10801-7760
Phone (914) 607-5800

210 Westchester Ave
White Plains, NY 10604-2901
Phone (914) 682-0700

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
009985NYMDMental Health Counselor
58193CAMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Northeast Medical Group, Inc. CurrentSince Jul 25, 2016 Accepting new patients
Westchester Medical Group, P.C. CurrentSince Jul 18, 2011 Accepting new patients
Northeast Medical Group, Inc CurrentSince Jul 25, 2016 Accepting new patients

Locations

5 Perryridge Rd
Greenwich, CT 06830
Phone (203) 661-5330

789 Howard Ave
North Haven, CT 06519
Phone (203) 688-2471

95 Armory Rd
Stratford, CT 06614
Phone (203) 384-3388

800 Westchester Ave
Ste N715
Rye Brook, NY 10573
Phone (914) 607-5730

210 Westchester Ave
White Plains, NY 10604
Phone (914) 681-3100

Networks

  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H9678

Interoperability endpoints

  • Direct secure messaging: dwaxler@hiemail.healtheconnections.org
  • Direct secure messaging: diana.waxler.1@21260.direct.athenahealth.com

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1184889600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1627516800000",
    "number": "1164622858",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 WESTCHESTER AVE",
            "address_2": "STE N715",
            "city": "RYE BROOK",
            "state": "NY",
            "postal_code": "105731369",
            "telephone_number": "914-607-5730",
            "fax_number": "914-457-1195"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "210 WESTCHESTER AVE",
            "city": "WHITE PLAINS",
            "state": "NY",
            "postal_code": "106042901",
            "telephone_number": "914-681-3100",
            "fax_number": "914-682-6588"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAXLER",
        "first_name": "DIANA",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-07-20",
        "last_updated": "2021-07-29",
        "certification_date": "2021-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NY",
            "license": "009985",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in White Plains, NY

Sources for this page

Verify at the official NPI Registry.