Individual provider Active NPI

Thomas A Diakun, M.D.

  • Anesthesiology Physician
  • Buffalo, NY
National Provider Identifier
1679668305
Registry record updated Dec 23, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
169375-1 Issued in NY
Practice address
2121 Main Street
Suite 209
Buffalo, NY 14214
Phone
(716) 836-7510
Fax
(716) 836-7511
NPI assigned
Oct 4, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 23, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 169375-1 NY Primary

Addresses

Primary practice location

2121 Main Street
Suite 209
Buffalo, NY 14214

Mailing address

2121 Main St
Suite 209
Buffalo, NY 14214-2693
Phone (716) 836-7510

Other identifiers 1

IdentifierTypeStateIssuer
01042722MedicaidNY

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
I20121129000166 NY Practitioner - Anesthesiology 5395931117 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
State University of New York at Buffalo School of Medicine, 1983
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Parkside Medical Anesthesia AssociatesGroup PAC ID 7517854631, 31 clinicians

Practice addresses (Care Compare)

2157 Main St
Buffalo, NY 14214-2648
Phone (716) 836-7510

Hospital & facility affiliations

  • Sisters of Charity Hospital Hospital, Buffalo, NY, CCN 330078

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
169375-1NYMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Abbott Anesthesiologist Associates PC CurrentSince Feb 19, 2022 Accepting new patients
Parkside Medical Anesthesia Associates Anesthesiology CurrentSince May 1, 2001 Accepting new patients

Locations

515 Abbott Rd
Ste 410
Buffalo, NY 14220
Phone (716) 826-6628

2157 Main St
Buffalo, NY 14214
Phone (716) 862-1501

3871 Harlem Rd
Ste 202
Buffalo, NY 14215

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 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": "1159920000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1324598400000",
    "number": "1679668305",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2121 MAIN ST",
            "address_2": "SUITE 209",
            "city": "BUFFALO",
            "state": "NY",
            "postal_code": "142142693",
            "telephone_number": "716-836-7510",
            "fax_number": "716-836-7511"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2121 MAIN STREET",
            "address_2": "SUITE 209",
            "city": "BUFFALO",
            "state": "NY",
            "postal_code": "14214",
            "telephone_number": "716-836-7510",
            "fax_number": "716-836-7511"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIAKUN",
        "first_name": "THOMAS",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-04",
        "last_updated": "2011-12-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "NY",
            "license": "169375-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01042722",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Buffalo, NY

Sources for this page

Verify at the official NPI Registry.