Individual provider Active NPI

Diana M Sambuco, MS, NP-C

  • Nurse Practitioner
  • New Hyde Park, NY
National Provider Identifier
1518399526
Registry record updated Aug 13, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
F306182-1 Issued in NY
Practice address
1999 Marcus Ave
Suite 106B
New Hyde Park, NY 11042-1033
Phone
(516) 233-3701
NPI assigned
Jul 31, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 13, 2013

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X F306182-1 NY Primary
Adult Health Nurse Practitioner 363LA2200X F306182-1 NY

Addresses

Primary practice location

1999 Marcus Ave
Suite 106B
New Hyde Park, NY 11042-1033

Mailing address

1999 Marcus Ave
Suite 106B
New Hyde Park, NY 11042-1033
Phone (516) 233-3701

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
I20140116000769 NY Practitioner - Nurse Practitioner 8224266358 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
F306182-1NYMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
North Shore-Lij Medical PC CurrentSince Oct 1, 2013 Accepting new patients
North Shore - Lij Medical PC CurrentSince Oct 1, 2013 Accepting new patients

Locations

10201 66th Rd
Forest Hills, NY 11375
Phone (718) 830-4091

27005 76th Ave
Rm 228
New Hyde Park, NY 11040
Phone (718) 470-7362

1999 Marcus Ave
Ste 106B
New Hyde Park, NY 11042
Phone (516) 233-3701

1999 Marcus Ave
#106
New Hyde Park, NY 11042
Phone (516) 233-3701

300 Community Dr
Plandome, NY 11030

972 Brush Hollow Rd
Westbury, NY 11590

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": "1375228800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1376352000000",
    "number": "1518399526",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1999 MARCUS AVE",
            "address_2": "SUITE 106B",
            "city": "NEW HYDE PARK",
            "state": "NY",
            "postal_code": "110421033",
            "telephone_number": "516-233-3701"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1999 MARCUS AVE",
            "address_2": "SUITE 106B",
            "city": "NEW HYDE PARK",
            "state": "NY",
            "postal_code": "110421033",
            "telephone_number": "516-233-3701"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SAMBUCO",
        "first_name": "DIANA",
        "middle_name": "M",
        "credential": "MS, NP-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-07-31",
        "last_updated": "2013-08-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NY",
            "license": "F306182-1",
            "primary": true
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NY",
            "license": "F306182-1",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New Hyde Park, NY

Sources for this page

Verify at the official NPI Registry.