Individual provider Active NPI

Jill M Diamond, AUD

  • Audiologist
  • Bayside, NY
National Provider Identifier
1568447548
Registry record updated Jan 21, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
AudiologistTaxonomy code 231H00000X
License
001917-1 Issued in NY
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, 2010By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 21, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
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 IDStateProvider typePAC IDDetails
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

LicenseStateTypeSpecialty
001917-1NYMDAudiologist

Practice roles

OrganizationSpecialtyStatusNew 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.

Verify at the official NPI Registry.