Individual provider Active NPI

Thierno Neke Diallo

  • Family Nurse Practitioner
  • Bronx, NY
National Provider Identifier
1407470412
Registry record updated Oct 21, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
F345381 Issued in NY
Practice address
2015 Grand Concourse
Bronx, NY 10453-4303
Phone
(718) 299-7295
Fax
(718) 299-6797
NPI assigned
Jun 4, 2020
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 21, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 0888210 NY
Family Nurse Practitioner 363LF0000X F345381 NY Primary

Addresses

Primary practice location

2015 Grand Concourse
Bronx, NY 10453-4303

Mailing address

1434 Williamsbridge Rd FL 2
Bronx, NY 10461-2507
Phone (718) 618-0401

Other practice location 1

21403B Hillside Ave
Queens Village, NY 11427-1857
Phone (917) 553-5983

Other practice location 2

21403B Hillside Ave # 3B
Queens Village, NY 11427-1857
Phone (917) 553-5993

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
I20200923000423 NY Practitioner - Nurse Practitioner 6406275502 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
House Call Medical Services of New York, PLLCGroup PAC ID 2264517754, 162 clinicians

Practice addresses (Care Compare)

2015 Grand Concourse
Bronx, NY 10453-4303

2626 Halperin Ave
FL 1
Bronx, NY 10461-2631

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0888210NYMDFamily Nurse Practitioner
F345381NYMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Essen Medical Urgicare, PLLC CurrentSince Jul 1, 2020 Accepting new patients
House Call Medical Services of New York, PLLC CurrentSince Jul 1, 2020 Accepting new patients
Bronx Medical Practice P.C. CurrentSince Jul 1, 2020 Accepting new patients
Essen Medical Associates, PC CurrentSince Jul 1, 2020 Accepting new patients
Essen Medical Associates, PC Current Accepting new patients
Essen Medical Associates,PC CurrentSince Jul 1, 2020 Accepting new patients

Locations

1434 Williamsbridge Rd
Fl 2
Bronx, NY 10461
Phone (201) 641-2125

2015 Grand Concourse
Bronx, NY 10453
Phone (718) 294-6200

1371 Seabury Ave
Bronx, NY 10461
Phone (718) 294-6200

2505 Grand Ave
Bronx, NY 10468
Phone (718) 295-1400

1550 Dr Martin L King Jr Blvd
Bronx, NY 10452
Phone (347) 269-2366

8989 Union Tpke
Ste A
Glendale, NY 11385
Phone (718) 746-0400

8989 Union Tpke
Glendale, NY 11385
Phone (718) 480-6207

Networks

  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H3359

Interoperability endpoints

  • Direct secure messaging: thierno.diallo@ema.eclinicaldirectplus.com

Organizations & group practices 6

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": "1591228800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603238400000",
    "number": "1407470412",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1434 WILLIAMSBRIDGE RD FL 2",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104612507",
            "telephone_number": "718-618-0401",
            "fax_number": "347-479-1303"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2015 GRAND CONCOURSE",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104534303",
            "telephone_number": "718-299-7295",
            "fax_number": "718-299-6797"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "21403B Hillside Ave",
            "address_purpose": "LOCATION",
            "city": "Queens Village",
            "state": "NY",
            "postal_code": "114271857",
            "country_code": "US",
            "telephone_number": "917-553-5983",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "21403B Hillside Ave # 3B",
            "address_purpose": "LOCATION",
            "city": "Queens Village",
            "state": "NY",
            "postal_code": "114271857",
            "country_code": "US",
            "telephone_number": "917-553-5993",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DIALLO",
        "first_name": "THIERNO",
        "middle_name": "NEKE",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-06-04",
        "last_updated": "2020-10-21",
        "certification_date": "2020-10-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "0888210",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "F345381",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bronx, NY

Sources for this page

Verify at the official NPI Registry.