Individual provider Active NPI

Diana C Santori, MS PA-C

  • Surgical Physician Assistant
  • Stony Brook, NY
National Provider Identifier
1487962023
Registry record updated Oct 15, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
014182 Issued in NY
Practice address
Stony Brook University Medical Ctr
Stony Brook, NY 11794-8122
Phone
(516) 242-8474
NPI assigned
Sep 16, 2010
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 15, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 014182 NY
Surgical Physician Assistant 363AS0400X 014182 NY Primary

Addresses

Primary practice location

Stony Brook University Medical Ctr
Stony Brook, NY 11794-8122

Mailing address

67 Bernard St
Massapequa, NY 11758-3606
Phone (516) 242-8474

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110215000123 NY Practitioner - Physician Assistant 1052591633 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
State University of New York at Stony Brook, School of Medicine, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1 Lauterbur Dr
Stony Brook Cancer Center
Stony Brook, NY 11794-0001
Phone (631) 444-1213

100 Nicolls Rd
Stony Brook, NY 11794-8122
Phone (631) 444-1213

101 Nicolls Rd
Stony Brook, NY 11794-8122
Phone (631) 444-1213

Hospital & facility affiliations

  • Suny/Stony Brook University Hospital Hospital, Stony Brook, NY, CCN 330393

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science, Physician Assistant

Networks

  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H1722

Interoperability endpoints

  • Direct secure messaging: diana.peers@direct.stonybrookmedicine.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.

Hospital & facility affiliations 6

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

NPI Registry JSON

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

{
    "created_epoch": "1284595200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1539561600000",
    "number": "1487962023",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "67 BERNARD ST",
            "city": "MASSAPEQUA",
            "state": "NY",
            "postal_code": "117583606",
            "telephone_number": "516-242-8474",
            "fax_number": "516-798-6971"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "STONY BROOK UNIVERSITY MEDICAL CTR",
            "city": "STONY BROOK",
            "state": "NY",
            "postal_code": "117948122",
            "telephone_number": "516-242-8474"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANTORI",
        "first_name": "DIANA",
        "middle_name": "C",
        "credential": "MS PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-09-16",
        "last_updated": "2018-10-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NY",
            "license": "014182",
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "NY",
            "license": "014182",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Stony Brook, NY

Sources for this page

Verify at the official NPI Registry.