Individual provider Active NPI

Diane S Correia, DO

  • Anesthesiology Physician
  • Garden City, NY
National Provider Identifier
1508908005
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
175615 1 Issued in NY
Practice address
711 Stewart Avenue
Suite 114
Garden City, NY 11530
Phone
(516) 227-3254
Fax
(516) 998-4078
NPI assigned
Feb 12, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 175615 1 NY Primary

Addresses

Primary practice location

711 Stewart Avenue
Suite 114
Garden City, NY 11530

Mailing address

711 Stewart Avenue
Suite 114
Garden City, NY 11530
Phone (516) 227-3254

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040406001589 NY Practitioner - Anesthesiology 1153314083 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy, Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
175615 1NYMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Endoscopy Center of Long Island LLC CurrentSince May 22, 2009 Accepting new patients
North Shore - Lij Anesthesiology, PC Anesthesiology CurrentSince Apr 4, 2017 Accepting new patients

Locations

711 Stewart Ave
Ste 114
Garden City, NY 11530
Phone (516) 227-3254

195 E Main St
Huntington, NY 11743
Phone (631) 385-8677

Networks

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

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1171238400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1508908005",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "711 STEWART AVENUE",
            "address_2": "SUITE 114",
            "city": "GARDEN CITY",
            "state": "NY",
            "postal_code": "11530",
            "telephone_number": "516-227-3254",
            "fax_number": "516-998-4078"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "711 STEWART AVENUE",
            "address_2": "SUITE 114",
            "city": "GARDEN CITY",
            "state": "NY",
            "postal_code": "11530",
            "telephone_number": "516-227-3254",
            "fax_number": "516-998-4078"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CORREIA",
        "first_name": "DIANE",
        "middle_name": "S",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-12",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "NY",
            "license": "175615 1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Garden City, NY

Sources for this page

Verify at the official NPI Registry.