Individual provider Active NPI

Barry Lawrence Diener, M.D.

  • Pediatric Pulmonology Physician
  • East Setauket, NY
National Provider Identifier
1629366372
Registry record updated Jun 25, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Pulmonology PhysicianTaxonomy code 2080P0214X
License
274091 Issued in NY
Practice address
4 Technology Dr
East Setauket, NY 11733-4080
Phone
(631) 444-8340
Fax
(631) 444-6045
NPI assigned
Jul 15, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 25, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Pulmonology Physician 2080P0214X MD441936 PA
Pediatric Pulmonology Physician 2080P0214X 274091 NY Primary

Addresses

Primary practice location

4 Technology Dr
East Setauket, NY 11733-4080

Mailing address

PO Box 1559
Stony Brook, NY 11790-0989
Phone (631) 444-8014

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140606000223 NY Practitioner - Pulmonary DiseasePractitioner - Pediatric Medicine 4880818186 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pulmonary DiseaseAlso: Pediatric Medicine
Education
New York Medical College, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

100 Nicolls Rd
Stony Brook, NY 11794-3407
Phone (631) 444-7653

2701 Sunrise Hwy
Islip Terrace, NY 11752-2642
Phone (631) 638-2375

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
274091NYMDPediatric Pulmonology Physician
MD441936PAMDPediatric Pulmonology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Stony Brook Children'S Service, University Faculty Practice Corporatio CurrentSince Jul 14, 2014 Accepting new patients
Stony Brook Surgical Associates, University Faculty Practice Corporati Past Accepting new patients
Neurology Associates of Stony Brook, University Faculty Practice Corpo Past Accepting new patients

Locations

500 Commack Rd
Ste 104
Commack, NY 11725
Phone (631) 638-0150

2701 Sunrise Hwy
Islip Terrace, NY 11752
Phone (631) 444-6300

4 Smith Haven Mall
Ste 101
Lake Grove, NY 11755
Phone (631) 444-7337

4 Technology Dr
Setauket, NY 11733
Phone (631) 444-2700

Networks

  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H3359

Interoperability endpoints

  • Direct secure messaging: barry.diener@direct.stonybrookmedicine.edu

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1310688000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1403654400000",
    "number": "1629366372",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1559",
            "city": "STONY BROOK",
            "state": "NY",
            "postal_code": "117900989",
            "telephone_number": "631-444-8014",
            "fax_number": "631-444-6045"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4 TECHNOLOGY DR",
            "city": "EAST SETAUKET",
            "state": "NY",
            "postal_code": "117334080",
            "telephone_number": "631-444-8340",
            "fax_number": "631-444-6045"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIENER",
        "first_name": "BARRY",
        "middle_name": "LAWRENCE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-07-15",
        "last_updated": "2014-06-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0214X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Pulmonology",
            "state": "PA",
            "license": "MD441936",
            "primary": false
        },
        {
            "code": "2080P0214X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Pulmonology",
            "state": "NY",
            "license": "274091",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in East Setauket, NY

Sources for this page

Verify at the official NPI Registry.