Active NPI
Diane A Collins, FNP-C
- Family Nurse Practitioner
- New York, NY
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- 353246
- Practice address
- 622 W 168TH St PH 5-505
New York, NY 10032-3720 - Phone
- (212) 305-6494
- NPI assigned
- Dec 20, 2020
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 11009758 | FL | |
| Family Nurse Practitioner | 363LF0000X | 353246 | NY | Primary |
Addresses
Primary practice location
622 W 168TH St PH 5-505
New York, NY 10032-3720
Mailing address
2424 Huron Cir
Kissimmee, FL 34746-3437
Phone (754) 207-6565
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: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Nurse Practitioner
- Education
- Other, 2019
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
1295 Broadway
Brooklyn, NY 11221-2973
Phone (718) 682-3903
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 11009758 | FL | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Trustees of Columbia University in the City of New York | Current | Accepting new patients | |
| Kings Medical Family Practice PC | Current | Accepting new patients | |
| Trustees of Columbia University in the City of New York | Current | Accepting new patients | |
| Ag Urgent Care, P.C. | Current | Accepting new patients | |
| Trustees of Columbia University in the City of New York | Current | Accepting new patients |
Locations
4809 Avenue N
Brooklyn, NY 11234
Phone (718) 252-4120
9525 Church Ave
Brooklyn, NY 11212
Phone (718) 513-6178
9525 Church Ave
#Y
Brooklyn, NY 11212
1771 Utica Ave
Brooklyn, NY 11234
Phone (718) 209-0888
1295 Broadway
Brooklyn, NY 11221
Phone (718) 682-3903
16814 Jamaica Ave
Jamaica, NY 11432
Phone (718) 650-5553
622 W 168th St
New York, NY 10032
Phone (212) 305-4931
161 Fort Washington Ave
New York, NY 10032
Phone (212) 305-8559
622 W 168th St
Ph 5505
New York, NY 10032
Phone (212) 305-6494
Interoperability endpoints
- https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/R4/
- https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/DSTU2/
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.
-
- Family Medicine Physician
- Brooklyn, NY
- NPI 1316461387
-
- Surgery Physician
- New York, NY
- NPI 1508266347
-
- Internal Medicine Physician
- New York, NY
- NPI 1699289488
-
- Internal Medicine Physician
- New York, NY
- NPI 1861907321
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1608422400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1730764800000",
"number": "1205422649",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2424 HURON CIR",
"city": "KISSIMMEE",
"state": "FL",
"postal_code": "347463437",
"telephone_number": "754-207-6565"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "622 W 168TH ST PH 5-505",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100323720",
"telephone_number": "212-305-6494"
}
],
"practiceLocations": [],
"basic": {
"last_name": "COLLINS",
"first_name": "DIANE",
"middle_name": "A",
"credential": "FNP-C",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2020-12-20",
"last_updated": "2024-11-05",
"certification_date": "2024-11-04",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "FL",
"license": "11009758",
"primary": false
},
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "NY",
"license": "353246",
"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 Nov 5, 2024; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.