Active NPI
Diane B. Lucks, MIDWIFE
- Advanced Practice Midwife
- Massapequa, NY
National Provider Identifier
1457435224
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Advanced Practice Midwife
- License
- F000126-1
- Practice address
- 79 Grand Ave
Massapequa, NY 11758-4905 - Phone
- (516) 798-3376
- Fax
- (516) 798-5882
- NPI assigned
- Oct 25, 2006
- Last updated
- Mar 7, 2023
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Advanced Practice Midwife | 367A00000X | F000126 | NY | |
| Advanced Practice Midwife | 367A00000X | F000126-1 | NY | Primary |
| Nurse Practitioner | 363L00000X | 376143-1 | NY |
Addresses
Primary practice location
79 Grand Ave
Massapequa, NY 11758-4905
Mailing address
200 Garden City Plaza
Suite 100
Garden City, NY 11530
Phone (516) 663-6400
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| F00126 | Other | NY | MIDWIFE LICENSE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Certified Nurse Midwife
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 376143-1 | NY | MD | Nurse Practitioner |
| F000126-1 | NY | MD | Advanced Practice Midwife |
Networks
- Healthfirst Medicare Network H3359
- Healthfirst Medicare Network H5989
- Healthfirst Medicare Network H1722
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1161734400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1678147200000",
"number": "1457435224",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "200 GARDEN CITY PLAZA",
"address_2": "SUITE 100",
"city": "GARDEN CITY",
"state": "NY",
"postal_code": "11530",
"telephone_number": "516-663-6400",
"fax_number": "516-663-6404"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "79 GRAND AVE",
"city": "MASSAPEQUA",
"state": "NY",
"postal_code": "117584905",
"telephone_number": "516-798-3376",
"fax_number": "516-798-5882"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LUCKS",
"first_name": "DIANE",
"middle_name": "B.",
"name_prefix": "Ms.",
"credential": "MIDWIFE",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-10-25",
"last_updated": "2023-03-07",
"status": "A"
},
"taxonomies": [
{
"code": "367A00000X",
"taxonomy_group": "",
"desc": "Advanced Practice Midwife",
"state": "NY",
"license": "F000126",
"primary": false
},
{
"code": "367A00000X",
"taxonomy_group": "",
"desc": "Advanced Practice Midwife",
"state": "NY",
"license": "F000126-1",
"primary": true
},
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "NY",
"license": "376143-1",
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MIDWIFE LICENSE",
"identifier": "F00126",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}Other providers in Massapequa, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.