Diane Iragena Shumbusho, MD

Primary specialty

Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X

License

328335 Issued in NY

Practice address

1575 Washington St
Watertown, NY 13601-9371

Phone

(315) 785-4155

Fax

(315) 779-5066

NPI assigned

May 16, 2016

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Diane Iragena Bizimana Former name

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

Specialty

Obstetrics/Gynecology

Education

Other, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Samaritan Medical CenterGroup PAC ID 8123914876, 157 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Samaritan Medical Center Hospital, Watertown, NY, CCN 330157

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: diane.shumbusho@sfhcny.eclinicaldirectplus.com

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.

• Samaritan Medical Center

  • General Acute Care Hospital
  • Watertown, NY
  • NPI 1598713745
  Medicare reassignment Care Compare group NPD
• Samaritan Medical Center

  • Rehabilitation Hospital Unit
  • Watertown, NY
  • NPI 1093722068
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Samaritan Medical Center

  • General Acute Care Hospital
  • Watertown, NY
  • NPI 1598713745
  Care Compare affiliation

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

{
    "created_epoch": "1463356800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1713312000000",
    "number": "1457708802",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1575 WASHINGTON ST",
            "city": "WATERTOWN",
            "state": "NY",
            "postal_code": "136019371",
            "telephone_number": "315-785-4155",
            "fax_number": "315-779-5066"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1575 WASHINGTON ST",
            "city": "WATERTOWN",
            "state": "NY",
            "postal_code": "136019371",
            "telephone_number": "315-785-4155",
            "fax_number": "315-779-5066"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "11050 Mount Belvedere Blvd",
            "address_purpose": "LOCATION",
            "city": "Fort Drum",
            "state": "NY",
            "postal_code": "136025438",
            "country_code": "US",
            "telephone_number": "315-779-5385",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHUMBUSHO",
        "first_name": "DIANE",
        "middle_name": "IRAGENA",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-05-16",
        "last_updated": "2024-04-17",
        "certification_date": "2022-05-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "VA",
            "license": "0101264178",
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "NY",
            "license": "328335",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DIANE",
            "last_name": "BIZIMANA",
            "middle_name": "IRAGENA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Richard G Sherry, M.D.
• Valery Shikverg, MD
• Leanna Shippee
• Danielle Elizabeth Shirkey, MS CCC SLP
• Amy Shockley
• Emile Shumbusho, MD
• Ira Roger Siegel, PHARMACIST
• Benjamin R. Sigmond, M.D., C.W.S.
• Patricia V Signor, RPH.
• Shawn Michael Signor, PHARMD

• Obstetrics & Gynecology Physician in Watertown, NY
• Providers in Watertown, NY by specialty
• Obstetrics & Gynecology Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 17, 2024; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.