Individual provider Active NPI

Azetta Kindo-Diouf, N.P.

  • Family Medicine Physician
  • New York, NY
National Provider Identifier
1306152921
Registry record updated Sep 18, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
F336217 Issued in NY
Practice address
2369 2ND Ave
New York, NY 10035-3108
Phone
(914) 610-8789
NPI assigned
Aug 19, 2010
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 18, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X F336217 NY Primary

Addresses

Primary practice location

2369 2ND Ave
New York, NY 10035-3108

Mailing address

185 Brookside Ave
Mount Vernon, NY 10553-1347
Phone (914) 610-8789

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120417000569 NY Practitioner - Nurse Practitioner 6507027687 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Symphony Medical PCGroup PAC ID 5890916068, 55 clinicians

Practice addresses (Care Compare)

967 N Bdway
Yonkers, NY 10701-1301
Phone (914) 798-8956

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
F336217NYMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Symphony Medical PC CurrentSince Jan 1, 2019 Accepting new patients
Symphony Medical PC CurrentSince Jan 1, 2019 Accepting new patients

Locations

1088 N Broadway
Yonkers, NY 10701
Phone (914) 964-4965

967 N Broadway
Yonkers, NY 10701
Phone (914) 798-8956

2 Park Ave
Yonkers, NY 10703
Phone (914) 964-7300

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/23390/brand/1/csg/1/fhir/r4

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 1

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": "1282176000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1347926400000",
    "number": "1306152921",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "185 BROOKSIDE AVE",
            "city": "MOUNT VERNON",
            "state": "NY",
            "postal_code": "105531347",
            "telephone_number": "914-610-8789"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2369 2ND AVE",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100353108",
            "telephone_number": "914-610-8789"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KINDO-DIOUF",
        "first_name": "AZETTA",
        "name_prefix": "Mrs.",
        "credential": "N.P.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-08-19",
        "last_updated": "2012-09-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NY",
            "license": "F336217",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.