Individual provider Active NPI

John C Diamantis, INTERN

  • Social Worker
  • New York, NY
National Provider Identifier
1316466410
Registry record updated Jun 20, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
Practice address
135 W 50TH St
New York, NY 10020-1201
Phone
(212) 582-9100
NPI assigned
Sep 11, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 20, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X Primary

Addresses

Primary practice location

135 W 50TH St
New York, NY 10020-1201

Mailing address

714 College PL
College Point, NY 11356-1038
Phone (347) 624-0480

Other identifiers 1

IdentifierTypeStateIssuer
0001111234MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250331000831 VA Practitioner - Clinical Social Worker 9335662451 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2018
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

6350 Ctr Dr
Suite 106
Norfolk, VA 23502-4107
Phone (757) 559-1690

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Light and Life Therapy LLC CurrentSince Feb 18, 2025 Accepting new patients

Locations

6350 Center Dr
Ste 106
Norfolk, VA 23502
Phone (757) 227-3072

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1505088000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1529452800000",
    "number": "1316466410",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "714 COLLEGE PL",
            "city": "COLLEGE POINT",
            "state": "NY",
            "postal_code": "113561038",
            "telephone_number": "347-624-0480"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "135 W 50TH ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100201201",
            "telephone_number": "212-582-9100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIAMANTIS",
        "first_name": "JOHN",
        "middle_name": "C",
        "credential": "INTERN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-09-11",
        "last_updated": "2018-06-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0001111234",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.