Mary D. Driesch, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

175630 Issued in NY

Practice address

160 Main St
Penn Yan, NY 14527-1204

Phone

(315) 536-2752

Fax

(315) 536-4005

NPI assigned

May 27, 2005

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Interoperability endpoints

• Direct secure messaging: mary.driesch@flch.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.

• Cannariato & Driesch Family Medicine, PC

  • Family Medicine Physician
  • Penn Yan, NY
  • NPI 1134317084
  NPD (past)

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

{
    "created_epoch": "1117152000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1358812800000",
    "number": "1508869199",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 423",
            "city": "PENN YAN",
            "state": "NY",
            "postal_code": "145270423",
            "telephone_number": "315-531-9102",
            "fax_number": "315-531-9103"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "160 MAIN ST",
            "city": "PENN YAN",
            "state": "NY",
            "postal_code": "145271204",
            "telephone_number": "315-536-2752",
            "fax_number": "315-536-4005"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DRIESCH",
        "first_name": "MARY",
        "middle_name": "D.",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-05-27",
        "last_updated": "2013-01-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NY",
            "license": "175630",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01108927",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• John T Demetros, D.C.
• Paula Marie Detar
• Jennifer M Dillon, MS, OTR/L
• Vicki June Dornberger, MA SLP
• Taryn Price Draxler, M.D.
• Danielle Dunne, LPC/LMHC
• Eaves Family Dental Group
• Edmund E Eaves
• Marilyn Eaves, DDS
• Edmund E & Marilyn Y Eaves PTR

• Family Medicine Physician in Penn Yan, NY
• Providers in Penn Yan, NY by specialty
• Family Medicine Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.