Active NPI
Diane Z. Deferrante, MD
- Geriatric Medicine (Family Medicine) Physician
- Baldwin Park, CA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Geriatric Medicine (Family Medicine) Physician
- License
- A60946
- Practice address
- 1011 Baldwin Park Blvd
Baldwin Park, CA 91706-5806 - Phone
- (626) 851-1011
- NPI assigned
- Nov 29, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Geriatric Medicine (Family Medicine) Physician | 207QG0300X | A60946 | CA | Primary |
Addresses
Primary practice location
1011 Baldwin Park Blvd
Baldwin Park, CA 91706-5806
Mailing address
1011 Baldwin Park Blvd
Baldwin Park, CA 91706-5806
Phone (626) 851-1011
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
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 60946 | CA | MD | Pediatric Dentist |
| A60946 | CA | MD | Geriatric Medicine (Family Medicine) Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Twin Tier Pathology Associates, PC | Current | Accepting new patients | |
| Our Lady of Lourdes Memorial Hospital Inc. | Current | Accepting new patients | |
| Our Lady of Lourdes Memorial Hospital, Inc. | Current | Accepting new patients | |
| Loretto Health and Rehabilitation Center | Current | Accepting new patients |
Locations
3 Saint Anthony St
Auburn, NY 13021
Phone (315) 253-0351
169 Riverside Dr
Binghamton, NY 13905
Phone (607) 798-5111
169 Riverside Dr
Ste 206
Binghamton, NY 13905
Phone (607) 798-6701
700 E Brighton Ave
Syracuse, NY 13205
Phone (315) 469-5570
Interoperability endpoints
- ddeferrante196867@direct-guthrie.org
Ownership & related parties
All facility ownership & control disclosures 1
Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.
| Facility | Type | Role | Since |
|---|---|---|---|
| The Hospice at Lourdes | Hospice | Corporate Director | Jan 1, 2023 |
Owned or controlled facilities with NPI records 1
Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.
-
- Community Based Hospice Care Agency
- Vestal, NY
- NPI 1336197714
Corporate Director
Organizations & group practices 4
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.
-
- Skilled Nursing Facility
- Syracuse, NY
- NPI 1588650873
-
- General Acute Care Hospital
- Binghamton, NY
- NPI 1629087580
-
- Specialty Pharmacy
- Johnson City, NY
- NPI 1730982596
-
- Clinical Pathology/Laboratory Medicine Physician
- Binghamton, NY
- NPI 1770577470
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1164758400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1222128000000",
"number": "1548337447",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1011 BALDWIN PARK BLVD",
"city": "BALDWIN PARK",
"state": "CA",
"postal_code": "917065806",
"telephone_number": "626-851-1011"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1011 BALDWIN PARK BLVD",
"city": "BALDWIN PARK",
"state": "CA",
"postal_code": "917065806",
"telephone_number": "626-851-1011"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DEFERRANTE",
"first_name": "DIANE",
"middle_name": "Z.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-11-29",
"last_updated": "2008-09-23",
"status": "A"
},
"taxonomies": [
{
"code": "207QG0300X",
"taxonomy_group": "",
"desc": "Family Medicine, Geriatric Medicine",
"state": "CA",
"license": "A60946",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Baldwin Park, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.