Individual provider Active NPI

Diane Beth Tschudi, P.A.

  • Physician Assistant
  • Liverpool, NY
National Provider Identifier
1649568668
Registry record updated Mar 26, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
015184 Issued in NY
Practice address
5100 W Taft Rd
Suite 1C
Liverpool, NY 13088-3807
Phone
(315) 452-2333
Fax
(315) 452-2336
NPI assigned
Jul 11, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 26, 2013

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Physician Assistant 363A00000X 015184 NY Primary

Addresses

Primary practice location

5100 W Taft Rd
Suite 1C
Liverpool, NY 13088-3807

Mailing address

5100 W Taft Rd
Suite 1C
Liverpool, NY 13088-3807
Phone (315) 452-2333

Other identifiers 1

IdentifierTypeStateIssuer
03536523MedicaidNY

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
I20111027000398 NY Practitioner - Physician Assistant 1557534104 Reassigns benefits to 4 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
North Medical PC Current Accepting new patients
Samaritan Medical Center CurrentSince Sep 1, 2023 Accepting new patients

Locations

10881 US Route 11
Adams, NY 13605
Phone (315) 232-4400

5100 W Taft Rd
Ste 2T
Liverpool, NY 13088
Phone (315) 744-1592

5100 W Taft Rd
Ste 1C
Liverpool, NY 13088
Phone (315) 452-2333

830 Washington St
Watertown, NY 13601
Phone (315) 785-4000

Interoperability endpoints

  • Direct secure messaging: dtschudi88381@direct.upstate.edu

Organizations & group practices 6

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": "1310342400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1364256000000",
    "number": "1649568668",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5100 W TAFT RD",
            "address_2": "SUITE 1C",
            "city": "LIVERPOOL",
            "state": "NY",
            "postal_code": "130883807",
            "telephone_number": "315-452-2333",
            "fax_number": "315-452-2336"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5100 W TAFT RD",
            "address_2": "SUITE 1C",
            "city": "LIVERPOOL",
            "state": "NY",
            "postal_code": "130883807",
            "telephone_number": "315-452-2333",
            "fax_number": "315-452-2336"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TSCHUDI",
        "first_name": "DIANE",
        "middle_name": "BETH",
        "credential": "P.A.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-07-11",
        "last_updated": "2013-03-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "015184",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "03536523",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Liverpool, NY

Sources for this page

Verify at the official NPI Registry.