Active NPI
Diane Green
- Family Nurse Practitioner
- New York, NY
National Provider Identifier
1174900419
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- F35236701
- Practice address
- 9131 Queens BVLD
New York, NY 11373-9997 - Phone
- (718) 779-7000
- Fax
- (718) 697-6167
- NPI assigned
- May 6, 2015
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | F35236701 | NY | Primary |
Addresses
Primary practice location
9131 Queens BVLD
New York, NY 11373-9997
Mailing address
91 31 Queens Blvd
Elmhurst, NY 11373-9997
Phone (718) 779-7000
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| F35236701 | NY | MD | Family Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1430870400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1690934400000",
"number": "1174900419",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "91 31 QUEENS BLVD",
"city": "ELMHURST",
"state": "NY",
"postal_code": "113739997",
"telephone_number": "718-779-7000",
"fax_number": "718-697-6167"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9131 QUEENS BVLD",
"city": "NEW YORK",
"state": "NY",
"postal_code": "113739997",
"telephone_number": "718-779-7000",
"fax_number": "718-697-6167"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GREEN",
"first_name": "DIANE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2015-05-06",
"last_updated": "2023-08-02",
"certification_date": "2023-08-02",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "NY",
"license": "F35236701",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in New York, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 2, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.