Diamond State Primary Care, LLC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

DIAMOND STATE PRIMARY CARE, LLC

Practice address

1400 Peoples PLZ Ste 305
Newark, DE 19702-5708

Phone

(302) 838-2210

Fax

(302) 838-2129

NPI assigned

Nov 9, 2020

Organization subpart

No

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

Authorized official

Name

Dr. Imelyn Fernandez Lahey, MDNPI 1780999300

Title

Owner

Phone

(302) 838-2210

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in DE

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Imelyn F Lahey, M.D.

  • Family Medicine Physician
  • Newark, DE
  • NPI 1780999300
  Medicare reassignment Care Compare group NPD Authorized official
• Kathryn Caricchio, FNP-BC

  • Family Nurse Practitioner
  • Newark, DE
  • NPI 1912718818
  Medicare reassignment Care Compare group NPD
• Torianne Miranda Yetter, PA

  • Physician Assistant
  • Conowingo, MD
  • NPI 1760851299

  DE

  Medicare reassignment NPD

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

{
    "created_epoch": "1604880000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1606953600000",
    "number": "1386246940",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1400 PEOPLES PLZ STE 305",
            "city": "NEWARK",
            "state": "DE",
            "postal_code": "197025708",
            "telephone_number": "302-838-2210",
            "fax_number": "302-838-2129"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1400 PEOPLES PLZ STE 305",
            "city": "NEWARK",
            "state": "DE",
            "postal_code": "197025708",
            "telephone_number": "302-838-2210",
            "fax_number": "302-838-2129"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DIAMOND STATE PRIMARY CARE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-11-09",
        "last_updated": "2020-12-03",
        "certification_date": "2020-12-03",
        "status": "A",
        "authorized_official_last_name": "LAHEY",
        "authorized_official_first_name": "IMELYN",
        "authorized_official_middle_name": "FERNANDEZ",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "302-838-2210",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Diagnostic Medical Services Inc.
• Diamond Health Systems
• Diamond State Chiropractic Center, LLC
• Diamond State Chiropractic PA
• Diamond State Counseling, LLC
• Lindsey Diamond
• Matthew Anthony Diamond, MD
• Michael Diamond, PA-C
• Ivette Diaz Bracero
• Marco Paolo Diaz

• Family Medicine Physician in Newark, DE
• Providers in Newark, DE by specialty
• Family Medicine Physician in Delaware

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.