NPIMap

Individual provider Active NPI

Diana Leon, M.D.

  • Obstetrics & Gynecology Physician
  • Setauket, NY
National Provider Identifier
1649538554
Registry record updated Dec 3, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
262109 Issued in NY
Practice address
100 S Jersey Ave Unit 16
Setauket, NY 11733-2036
Phone
(631) 689-6400
NPI assigned
Apr 27, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 3, 2019

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics Physician 207VX0000X 262109 NY
Gynecology Physician 207VG0400X 262109 NY
Obstetrics & Gynecology Physician 207V00000X 262109 NY Primary

Addresses

Primary practice location

100 S Jersey Ave Unit 16
Setauket, NY 11733-2036

Mailing address

900 Merchants Concourse Ste 216
Westbury, NY 11590-5114
Phone (516) 226-8373

Other practice location 1

285 Sills Rd Ste D
East Patchogue, NY 11772-4869
Phone (631) 447-1032

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130820000642 NY Practitioner - Obstetrics/Gynecology 2062654122 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
Icahn School of Medicine at Mount Sinai, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Square Care Medical Group LLPGroup PAC ID 7012938434, 70 clinicians

Practice addresses (Care Compare)

100 S Jersey Ave
Unit 16
East Setauket, NY 11733-2036
Phone (631) 689-6400

Hospital & facility affiliations

  • Suny/Stony Brook University Hospital Hospital, Stony Brook, NY, CCN 330393
  • John T Mather Memorial Hospital of Port Jefferson Hospital, Port Jefferson, NY, CCN 330185
  • Long Island Community Hospital Hospital, Patchogue, NY, CCN 330141

Merit-based Incentive Payment System (MIPS)

Final score
87.62 of 100Reported as group
Quality
88.76
Promoting interoperability
100
Improvement activities
40
Cost
69.99

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
262109NYMDGynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University Hospital at Stony Brook Past Accepting new patients

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 and National Provider Directory roles.

Hospital & facility affiliations 9

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": "1335484800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1575331200000",
    "number": "1649538554",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "900 MERCHANTS CONCOURSE STE 216",
            "city": "WESTBURY",
            "state": "NY",
            "postal_code": "115905114",
            "telephone_number": "516-226-8373"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 S JERSEY AVE UNIT 16",
            "city": "SETAUKET",
            "state": "NY",
            "postal_code": "117332036",
            "telephone_number": "631-689-6400"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "285 Sills Rd Ste D",
            "address_purpose": "LOCATION",
            "city": "East Patchogue",
            "state": "NY",
            "postal_code": "117724869",
            "country_code": "US",
            "telephone_number": "631-447-1032",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LEON",
        "first_name": "DIANA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-04-27",
        "last_updated": "2019-12-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207VX0000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Obstetrics",
            "state": "NY",
            "license": "262109",
            "primary": false
        },
        {
            "code": "207VG0400X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Gynecology",
            "state": "NY",
            "license": "262109",
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "NY",
            "license": "262109",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Setauket, NY

Sources for this page

Verify at the official NPI Registry.