Individual provider Active NPI

Emma Dayangco Dizon, FNP

  • Family Nurse Practitioner
  • Auburn, NY
National Provider Identifier
1619240249
Registry record updated Aug 3, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
F336078-1 Issued in NY
Practice address
161 Genesee St Ste 203
Auburn, NY 13021-3498
Phone
(315) 255-0947
Fax
(315) 255-0942
NPI assigned
Feb 13, 2012
Last updated
Aug 3, 2022By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 3, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X F336078-1 NY Primary

Addresses

Primary practice location

161 Genesee St Ste 203
Auburn, NY 13021-3498

Mailing address

60 Main Street
Port Byron, NY 13140-0359
Phone (315) 776-9700

Other practice location 1

14 Maiden Ln
Penn Yan, NY 14527-1208
Phone (315) 531-9102

Other practice location 2

37 W Garden St Ste 201
Auburn, NY 13021-2657
Phone (315) 567-0777

Other identifiers 1

IdentifierTypeStateIssuer
03508490MedicaidNY

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
I20150413000966 NY Practitioner - Nurse Practitioner 2668790114 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Auburn Community HospitalGroup PAC ID 2365346525, shared by 6 NPIs, 61 clinicians
Auburn Memorial Medical Services PCGroup PAC ID 6406931385, 121 clinicians

Practice addresses (Care Compare)

17 Lansing St
Auburn, NY 13021-1983
Phone (315) 255-7142

37 W Garden St
Suite 203
Auburn, NY 13021-2657
Phone (315) 567-0507

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
73.63 of 100Reported as group
Quality
64.83
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
75.68 of 100Reported as group
Quality
48.88
Promoting interoperability
91
Improvement activities
40
Cost
71.94

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
F336078-1NYMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Auburn Community Hospital CurrentSince Feb 3, 2022 Accepting new patients
Auburn Memorial Medical Services, PC CurrentSince Jun 8, 2020 Accepting new patients
Auburn Community Hospital CurrentSince Mar 1, 2021 Accepting new patients
Auburn Memorial Medical Services, PC CurrentSince Jun 8, 2020 Accepting new patients

Locations

161 Genesee St
Ste 106
Auburn, NY 13021
Phone (315) 567-0540

161 Genesee St
Ste 203
Auburn, NY 13021
Phone (315) 255-0947

17 Lansing St
#C
Auburn, NY 13021
Phone (315) 567-0455

37 W Garden St
Ste 201
Auburn, NY 13021
Phone (315) 567-0777

37 W Garden St
Ste 203
Auburn, NY 13021
Phone (315) 253-6257

77 Nelson St
Ste 120
Auburn, NY 13021
Phone (315) 252-7550

17 Lansing St
Sennett, NY 13021
Phone (315) 255-7011

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1329091200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1659484800000",
    "number": "1619240249",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "60 MAIN STREET",
            "city": "PORT BYRON",
            "state": "NY",
            "postal_code": "131400359",
            "telephone_number": "315-776-9700",
            "fax_number": "315-776-9701"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "161 GENESEE ST STE 203",
            "city": "AUBURN",
            "state": "NY",
            "postal_code": "130213498",
            "telephone_number": "315-255-0947",
            "fax_number": "315-255-0942"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "14 Maiden Ln",
            "address_purpose": "LOCATION",
            "city": "Penn Yan",
            "state": "NY",
            "postal_code": "145271208",
            "country_code": "US",
            "telephone_number": "315-531-9102",
            "fax_number": "315-531-9103",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "37 W Garden St Ste 201",
            "address_purpose": "LOCATION",
            "city": "Auburn",
            "state": "NY",
            "postal_code": "130212657",
            "country_code": "US",
            "telephone_number": "315-567-0777",
            "fax_number": "315-702-8393",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DIZON",
        "first_name": "EMMA",
        "middle_name": "DAYANGCO",
        "credential": "FNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-02-13",
        "last_updated": "2022-08-03",
        "certification_date": "2022-08-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "F336078-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "03508490",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Auburn, NY

Sources for this page

Verify at the official NPI Registry.