Individual provider Active NPI

Diane Folk, CNM

  • Advanced Practice Midwife
  • Syracuse, NY
National Provider Identifier
1417982638
Registry record updated Aug 22, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Advanced Practice MidwifeTaxonomy code 367A00000X
License
F000267-1 Issued in NY
Practice address
90 Presidential PLZ
3Rd Floor - Regional Perinatal Center
Syracuse, NY 13202-2240
Phone
(315) 464-4458
Fax
(315) 464-6388
NPI assigned
Jul 12, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Advanced Practice Midwife 367A00000X F000267-1 NY Primary

Addresses

Primary practice location

90 Presidential PLZ
3Rd Floor - Regional Perinatal Center
Syracuse, NY 13202-2240

Mailing address

90 Presidential PLZ
3Rd Floor - Regional Perinatal Center
Syracuse, NY 13202-2240
Phone (315) 464-4458

Other identifiers 1

IdentifierTypeStateIssuer
01745633MedicaidNY

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: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040510001168 NY Practitioner - Certified Nurse Midwife (CNM) 7315936804 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Nurse Midwife (CNM)
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Upstate Community Medical, PCGroup PAC ID 0143238782, 153 clinicians

Practice addresses (Care Compare)

4900 Broad Rd
Syracuse, NY 13215-2265
Phone (315) 492-5678

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Midwife

State licenses

LicenseStateTypeSpecialty
000267NYMDBehavioral Analyst
F000267-1NYMDAdvanced Practice Midwife

Practice roles

OrganizationSpecialtyStatusNew patients
Upstate Community Medical, PC CurrentSince Oct 1, 2020 Accepting new patients

Locations

4900 Broad Rd
Syracuse, NY 13215
Phone (315) 492-5011

4900 Broad Rd
Ste 2G
Syracuse, NY 13215
Phone (315) 299-5313

1001 W Fayette St
Ste 400
Syracuse, NY 13204
Phone (315) 472-1488

4900 Broad Rd
Ste 4H
Syracuse, NY 13215
Phone (315) 492-5678

Interoperability endpoints

  • Direct secure messaging: dfolk12745@direct.upstate.edu

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": "1152662400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1377129600000",
    "number": "1417982638",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "90 PRESIDENTIAL PLZ",
            "address_2": "3RD FLOOR - REGIONAL PERINATAL CENTER",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132022240",
            "telephone_number": "315-464-4458",
            "fax_number": "315-464-6388"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "90 PRESIDENTIAL PLZ",
            "address_2": "3RD FLOOR - REGIONAL PERINATAL CENTER",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132022240",
            "telephone_number": "315-464-4458",
            "fax_number": "315-464-6388"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FOLK",
        "first_name": "DIANE",
        "credential": "CNM",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-12",
        "last_updated": "2013-08-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367A00000X",
            "taxonomy_group": "",
            "desc": "Advanced Practice Midwife",
            "state": "NY",
            "license": "F000267-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01745633",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Syracuse, NY

Sources for this page

Verify at the official NPI Registry.