Gregory John Diehl, MD

Primary specialty

Plastic Surgery PhysicianTaxonomy code 208200000X

License

1902162 Issued in NY

Practice address

1500 Route 112 BLDG # 10
Port Jefferson Station, NY 11776

Phone

(631) 476-7300

Fax

(631) 476-7304

NPI assigned

Oct 14, 2005

Last updated

May 20, 2020By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Electronic endpoints 1

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

State licenses

Interoperability endpoints

• Direct secure messaging: gdiehl@directaddress.net

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Gregory J Diehl MD PC

  • Medical Specialty Clinic/Center
  • Port Jefferson Station, NY
  • NPI 1235436130
  Authorized official Same address or phone

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

{
    "created_epoch": "1129248000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1589932800000",
    "number": "1447249214",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1500 ROUTE 112",
            "address_2": "BLDG 10",
            "city": "PORT JEFFERSON STATION",
            "state": "NY",
            "postal_code": "117763184",
            "telephone_number": "631-476-7300",
            "fax_number": "631-476-7304"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 ROUTE 112 BLDG # 10",
            "city": "PORT JEFFERSON STATION",
            "state": "NY",
            "postal_code": "11776",
            "telephone_number": "631-476-7300",
            "fax_number": "631-476-7304"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIEHL",
        "first_name": "GREGORY",
        "middle_name": "JOHN",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-10-14",
        "last_updated": "2020-05-20",
        "certification_date": "2020-05-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208200000X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery",
            "state": "NY",
            "license": "1902162",
            "primary": true
        },
        {
            "code": "2082S0105X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery, Surgery of the Hand",
            "state": "NY",
            "license": "1902162",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "GDiehl@Directaddress.net",
            "affiliation": "N",
            "endpointDescription": "direct message",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "XML",
            "address_1": "1500 Route 112 Bldg # 10",
            "city": "Port Jefferson Station",
            "state": "NY",
            "country_code": "US",
            "postal_code": "11776",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• William J Di Scipio, PH.D.
• Diane a Gariepy LCSW PC
• Jennifer Marie Diaz, MD
• Gary P Dibenedetto, DC
• Daryl P Didio, PHD
• Nora Difabio
• Stacey Digiacomo, P.A.
• Peter Dilauro, LPN
• Marina Dillon, FNP-C
• Donald Dodge

• Plastic Surgery Physician in Port Jefferson Station, NY
• Providers in Port Jefferson Station, NY by specialty
• Plastic Surgery Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 2020; 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.