Diane M Clausen, M.D.
Individual provider Active NPI Hematology & Oncology Physician · E Setauket, NY
NPI 1447256995 · NPPES record last updated Aug 20, 2019
Key facts
- NPI
- 1447256995
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Hematology & Oncology Physician 207RH0003X
- License
- 186523 (NY)
- Practice address
- 235 N Belle Mead Rd
E Setauket, NY 11733-3456 - Phone
- (631) 751-3000
- Fax
- (631) 675-2001
- NPI assigned
- Jun 21, 2005
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NY
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20050603000503 | NY | Practitioner - Hospice/Palliative Care |
7810930526 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 186523 | NY | MD | Hematology & Oncology Physician |
Practice roles (1 of 5)
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Good Shepherd Hospice | Current |
Accepting new patients |
Locations
110 Bi County Blvd
Ste 114
Farmingdale, NY 11735
Phone (631) 465-6300
Networks
- Healthfirst Medicare Network H1722
- Healthfirst Medicare Network H5989
- Healthfirst Medicare Network H3359
- Healthfirst Medicare Network H9678
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Hematology & Oncology Physician | 207RH0003X | 186523 | NY | Yes |
Addresses
Primary practice location
235 N Belle Mead Rd
E Setauket, NY 11733-3456
Mailing address
1500 Route 112
BLDG 4
Port Jefferson Station, NY 11776-8055
Phone (631) 751-3000
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 01681621 | Medicaid | NY |
Other providers in E Setauket, NY
- Sherline Agena
- Edward W Antos Jr.
- Janet Badalamenti
- Theresa Blumenthal
- Alisha Marie Constantino
- Theresa Crafa
- Kristina Demarco
- Mary Ann Fragola
- Alexea M Gaffney-Adams
All providers in E Setauket, NY · Hematology & Oncology Physician in New York
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 20, 2019. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.