Dianna Stade Gagnon, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

MD25864 Issued in ME

Practice address

90 Bridge St Ste 432
Westbrook, ME 04092-2948

Phone

(207) 619-0315

Fax

(207) 481-8369

NPI assigned

Jun 10, 2019

Last updated

Aug 25, 2022By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Dianna Stade Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Nov 11, 2022 through Nov 11, 2026

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Interoperability endpoints

• Direct secure messaging: dianna.stade.1@15948.direct.athenahealth.com

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

{
    "created_epoch": "1560124800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1661385600000",
    "number": "1184283665",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "90 BRIDGE ST STE 432",
            "city": "WESTBROOK",
            "state": "ME",
            "postal_code": "040922948",
            "telephone_number": "207-619-0315",
            "fax_number": "207-481-8369"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "90 BRIDGE ST STE 432",
            "city": "WESTBROOK",
            "state": "ME",
            "postal_code": "040922948",
            "telephone_number": "207-619-0315",
            "fax_number": "207-481-8369"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "35 Medical Center Pkwy",
            "address_purpose": "LOCATION",
            "city": "Augusta",
            "state": "ME",
            "postal_code": "043308160",
            "country_code": "US",
            "telephone_number": "207-626-1000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "15 E Chestnut St",
            "address_purpose": "LOCATION",
            "city": "Augusta",
            "state": "ME",
            "postal_code": "043305736",
            "country_code": "US",
            "telephone_number": "207-626-1561",
            "fax_number": "207-626-1849",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "272 Congress St",
            "address_purpose": "LOCATION",
            "city": "Portland",
            "state": "ME",
            "postal_code": "041013637",
            "country_code": "US",
            "telephone_number": "207-874-2466",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GAGNON",
        "first_name": "DIANNA",
        "middle_name": "STADE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-06-10",
        "last_updated": "2022-08-25",
        "certification_date": "2022-08-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "ME",
            "license": "EC191062",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "ME",
            "license": "MD25864",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DIANNA",
            "last_name": "STADE",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Daniel Frost, BCBA
• Monica Fuller, BCBA
• Brittany Nicole Fulton, M.A., BCBA
• Mark K Fulton, MD
• Kelsi Gagne
• June Linden Gagnon, M.A.
• Michelle Gallagher
• Katie Garrity, LCSW
• Kayla Garvey, PHARMD, RPH
• Douglas Kent Gauvreau, O.D.

• Family Medicine Physician in Westbrook, ME
• Providers in Westbrook, ME by specialty
• Family Medicine Physician in Maine

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 25, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.