Individual provider Active NPI

Diamond Pendleton

  • Specialist
  • Forest Hills, NY
National Provider Identifier
1598009664
Registry record updated Feb 12, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
881699811 Issued in NY
Practice address
7000 Austin St
Suite 200
Forest Hills, NY 11375-1022
Phone
(718) 762-7633
Fax
(718) 886-8694
NPI assigned
Nov 15, 2012
Last updated
Feb 12, 2014By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 12, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 881699811 NY Primary

Addresses

Primary practice location

7000 Austin St
Suite 200
Forest Hills, NY 11375-1022

Mailing address

45 Clermont Ave
Apt 1M
Brooklyn, NY 11205-1157

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
881699811NYMDSpecialist

NPI Registry JSON

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

{
    "created_epoch": "1352937600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1392163200000",
    "number": "1598009664",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "45 CLERMONT AVE",
            "address_2": "APT 1M",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112051157"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7000 AUSTIN ST",
            "address_2": "SUITE 200",
            "city": "FOREST HILLS",
            "state": "NY",
            "postal_code": "113751022",
            "telephone_number": "718-762-7633",
            "fax_number": "718-886-8694"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PENDLETON",
        "first_name": "DIAMOND",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-11-15",
        "last_updated": "2014-02-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NY",
            "license": "881699811",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Forest Hills, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.