Laxmidhar Diwan, MD

Primary specialty

Sports Medicine (Orthopaedic Surgery) PhysicianTaxonomy code 207XX0005X

License

153779 Issued in NY

Practice address

6254 97TH PL
Suite 2H
Rego Park, NY 11374-1346

Phone

(718) 271-7700

Fax

(718) 271-4490

NPI assigned

Oct 19, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

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.

• Queens Arthroscopy & Sports Medicine

  • Sports Medicine (Orthopaedic Surgery) Physician
  • Rego Park, NY
  • NPI 1457554768
  NPD (past) Authorized official

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

{
    "created_epoch": "1161216000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1386726552",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6254 97TH PL",
            "address_2": "SUITE 2H",
            "city": "REGO PARK",
            "state": "NY",
            "postal_code": "113741346",
            "telephone_number": "718-271-7700",
            "fax_number": "718-271-4490"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6254 97TH PL",
            "address_2": "SUITE 2H",
            "city": "REGO PARK",
            "state": "NY",
            "postal_code": "113741346",
            "telephone_number": "718-271-7700",
            "fax_number": "718-271-4490"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIWAN",
        "first_name": "LAXMIDHAR",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-19",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207XX0005X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Sports Medicine",
            "state": "NY",
            "license": "153779",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Julia Raquel Diaz
• Dilip S. Doctor, MD PC
• Marialaina Dinunno
• Myrna D Diptee, MSW, LCSW
• Direct Family Care, Inc.
• DK Total Medical PC
• DME Pro USA Inc
• Dmitriy Yadgarov
• Richard Michael Dobbins, LCSW
• Lisa Dobro

• Sports Medicine (Orthopaedic Surgery) Physician in Rego Park, NY
• Providers in Rego Park, NY by specialty
• Sports Medicine (Orthopaedic Surgery) Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.