Diana Minasian Stulc, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

20783 Issued in MS

Practice address

969 Lakeland Dr
Jackson, MS 39216-4606

Phone

(615) 377-5658

Fax

(888) 241-1404

NPI assigned

Feb 16, 2006

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 identifiers 2

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

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

Credentials

Doctor of Medicine

Practice roles

Locations

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.

• Samaritan Hospital of Troy, New York

  • General Acute Care Hospital
  • Troy, NY
  • NPI 1043267727

  Family Medicine

  Medicare reassignment NPD
• St. Peter'S Hospital of the City of Albany

  • General Acute Care Hospital
  • Albany, NY
  • NPI 1518042357

  Family Medicine

  Medicare reassignment NPD
• St. Peter'S Hospital of the City of Albany

  • General Acute Care Hospital
  • Albany, NY
  • NPI 1497701106

  Family Medicine

  NPD
• Cogent Healthcare of Jackson Ms, LLC

  • Internal Medicine Physician
  • Jackson, MS
  • NPI 1699726836

  Family Medicine

  NPD (past)
• Cogent Healthcare of Kentucky, PSC

  • Internal Medicine Physician
  • Lexington, KY
  • NPI 1053362293

  Family Medicine

  NPD (past)

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

{
    "created_epoch": "1140048000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1261353600000",
    "number": "1225002165",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5410 MARYLAND WAY 300",
            "city": "BRENTWOOD",
            "state": "TN",
            "postal_code": "370725064",
            "telephone_number": "615-377-5658",
            "fax_number": "888-241-1404"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "969 LAKELAND DR",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392164606",
            "telephone_number": "615-377-5658",
            "fax_number": "888-241-1404"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STULC",
        "first_name": "DIANA",
        "middle_name": "MINASIAN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-02-16",
        "last_updated": "2009-12-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MS",
            "license": "20783",
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "KY",
            "license": "36090",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01139543",
            "state": "MS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "64024268",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Julie Beth Stuckless, OTR/L
• Noah Thomas Stuckless, RN
• John E Studdard, M.D.
• William Studdard, M.D.
• Tyler Thomas Studt, DMD
• Grace Gore Sturdivant, AU.D.
• Kristina Lynn Sturdivant, R.D., L.D.
• Sherice Shunta Stutts-Walker
• Angela R Subauste, MD
• Jose Santiago Subauste, M.D.

• Family Medicine Physician in Jackson, MS
• Providers in Jackson, MS by specialty
• Family Medicine Physician in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 21, 2009; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.