Individual provider Active NPI

Diane Lu, MMS, PA-C

  • Medical Physician Assistant
  • North Andover, MA
National Provider Identifier
1295277598
Registry record updated Jun 10, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
Practice address
198 Massachusetts Ave Ste 103
North Andover, MA 01845-4143
Phone
(978) 685-7550
NPI assigned
Nov 17, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 10, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X 020338 NY
Medical Physician Assistant 363AM0700X Primary

Addresses

Primary practice location

198 Massachusetts Ave Ste 103
North Andover, MA 01845-4143

Mailing address

1200 Elm St Unit 910
Manchester, NH 03101-2534

Other practice location 1

111 E 210th St
Bronx, NY 10467-2401
Phone (718) 920-4321

Other practice location 2

150 55th St
Brooklyn, NY 11220-2508
Phone (718) 630-7000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NH, MA2 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
I20231120002587 NH Practitioner - Physician Assistant 1254614241 Reassigns benefits to 1 organization
I20240110000275 MA Practitioner - Physician Assistant 1254614241 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
New England Ear Nose and Throat/Facial Plastic Surgery PCGroup PAC ID 8921192691, 16 clinicians

Practice addresses (Care Compare)

14 B Keewaydin Dr
Salem, NH 03079-2839
Phone (978) 686-5565

198 Massachusetts Ave
Suite 103
North Andover, MA 01845-4143
Phone (978) 685-7550

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science, Physician Assistant

State licenses

LicenseStateTypeSpecialty
2118NHMDOrthopedic Physical Therapist
020338NYMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Salem Hearing Center LLC PastSince Feb 7, 2021 Accepting new patients

Interoperability endpoints

  • Direct secure messaging: diane.lu.1@6597.direct.athenahealth.com

Organizations & group practices 2

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.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1479340800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717977600000",
    "number": "1295277598",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 ELM ST UNIT 910",
            "city": "MANCHESTER",
            "state": "NH",
            "postal_code": "031012534"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "198 MASSACHUSETTS AVE STE 103",
            "city": "NORTH ANDOVER",
            "state": "MA",
            "postal_code": "018454143",
            "telephone_number": "978-685-7550"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "111 E 210th St",
            "address_purpose": "LOCATION",
            "city": "Bronx",
            "state": "NY",
            "postal_code": "104672401",
            "country_code": "US",
            "telephone_number": "718-920-4321",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "150 55th St",
            "address_purpose": "LOCATION",
            "city": "Brooklyn",
            "state": "NY",
            "postal_code": "112202508",
            "country_code": "US",
            "telephone_number": "718-630-7000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LU",
        "first_name": "DIANE",
        "credential": "MMS, PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-11-17",
        "last_updated": "2024-06-10",
        "certification_date": "2024-06-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "NY",
            "license": "020338",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in North Andover, MA

Sources for this page

Verify at the official NPI Registry.