Active NPI
Amy Y Difabio, MD
- Pediatrics Physician
- Cortland, NY
National Provider Identifier
1306093091
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- 252407
- Practice address
- 24 Groton Ave
Cortland, NY 13045 - Phone
- (607) 753-3774
- NPI assigned
- Aug 25, 2008
- 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 |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 252407 | NY | Primary |
Addresses
Primary practice location
24 Groton Ave
Cortland, NY 13045
Mailing address
85 S West St
Homer, NY 13077-1542
Phone (607) 753-3797
Other practice location 1
24 Groton Ave
Cortland, NY 13045
Phone (607) 753-3774
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 03114707 | Medicaid | NY |
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)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 252407 | NY | MD | Pediatrics Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Family Health Network of Central New York, Inc. | Past | Accepting new patients | |
| East Hill Family Medical, Inc. | Pediatrics | Past | Accepting new patients |
| East Hill Family Medical, Inc. | Past | Accepting new patients |
Interoperability endpoints
- adifabio@ehfm.medentdirect.com
Organizations & group practices 3
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
- Auburn, NY
- NPI 1609813971
-
- Federally Qualified Health Center (FQHC)
- Homer, NY
- NPI 1811342827
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1219622400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1548720000000",
"number": "1306093091",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "85 S WEST ST",
"city": "HOMER",
"state": "NY",
"postal_code": "130771542",
"telephone_number": "607-753-3797",
"fax_number": "607-753-6677"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "24 GROTON AVE",
"city": "CORTLAND",
"state": "NY",
"postal_code": "13045",
"telephone_number": "607-753-3774"
}
],
"practiceLocations": [
{
"address_1": "24 Groton Ave",
"address_purpose": "LOCATION",
"city": "Cortland",
"state": "NY",
"postal_code": "13045",
"country_code": "US",
"telephone_number": "607-753-3774",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "DIFABIO",
"first_name": "AMY",
"middle_name": "Y",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-08-25",
"last_updated": "2019-01-29",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "NY",
"license": "252407",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "03114707",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}Other providers in Cortland, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.