Active NPI
Jill M Diamond, AUD
- Audiologist
- Bayside, NY
National Provider Identifier
1568447548
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Audiologist
- License
- 001917-1
- Practice address
- 21008 Northern Blvd
Suite 5
Bayside, NY 11361-3211 - Phone
- (718) 224-6100
- Fax
- (718) 224-8395
- NPI assigned
- Dec 13, 2005
- Last updated
- Jan 21, 2010
- 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 |
|---|---|---|---|---|
| Audiologist | 231H00000X | 001917-1 | NY | Primary |
Addresses
Primary practice location
21008 Northern Blvd
Suite 5
Bayside, NY 11361-3211
Mailing address
21008 Northern Blvd
Suite 5
Bayside, NY 11361-3211
Phone (718) 224-6100
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NY
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20060130000559 | NY | Practitioner - Qualified Audiologist | 4880608819 |
Care Compare profile
Medicare Care Compare- Specialty
- Qualified Audiologist
- Education
- Other, 2000
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
3022 Merrick Rd
Wantagh, NY 11793-4320
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 001917-1 | NY | MD | Audiologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| PCL Hearing Services of New York, LLC | Current | Accepting new patients | |
| Lawrence J. Deutsch PHD, PC | Audiologist | Past | Accepting new patients |
Locations
21008 Northern Blvd
Ste 5
Bayside, NY 11361
Phone (718) 224-6100
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1134432000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1264032000000",
"number": "1568447548",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "21008 NORTHERN BLVD",
"address_2": "SUITE 5",
"city": "BAYSIDE",
"state": "NY",
"postal_code": "113613211",
"telephone_number": "718-224-6100",
"fax_number": "718-224-8395"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "21008 NORTHERN BLVD",
"address_2": "SUITE 5",
"city": "BAYSIDE",
"state": "NY",
"postal_code": "113613211",
"telephone_number": "718-224-6100",
"fax_number": "718-224-8395"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DIAMOND",
"first_name": "JILL",
"middle_name": "M",
"name_prefix": "Dr.",
"credential": "AUD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2005-12-13",
"last_updated": "2010-01-21",
"status": "A"
},
"taxonomies": [
{
"code": "231H00000X",
"taxonomy_group": "",
"desc": "Audiologist",
"state": "NY",
"license": "001917-1",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Bayside, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 21, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.