Individual provider Active NPI

Dianna M Bastian, M.D.

  • Internal Medicine Physician
  • Phoenix, AZ
National Provider Identifier
1700869476
Registry record updated Jul 21, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
34793 Issued in AZ
Practice address
9100 N 2ND St
Suite 121
Phoenix, AZ 85020-2446
Phone
(602) 997-7331
Fax
(602) 870-4512
NPI assigned
Nov 27, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 34793 AZ Primary

Addresses

Primary practice location

9100 N 2ND St
Suite 121
Phoenix, AZ 85020-2446

Mailing address

9100 N 2ND St
Suite 121
Phoenix, AZ 85020-2446
Phone (602) 997-7331

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

NPI Registry JSON

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

{
    "created_epoch": "1133049600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1216598400000",
    "number": "1700869476",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9100 N 2ND ST",
            "address_2": "SUITE 121",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850202446",
            "telephone_number": "602-997-7331",
            "fax_number": "602-870-4512"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9100 N 2ND ST",
            "address_2": "SUITE 121",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850202446",
            "telephone_number": "602-997-7331",
            "fax_number": "602-870-4512"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BASTIAN",
        "first_name": "DIANNA",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-11-27",
        "last_updated": "2008-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "AZ",
            "license": "34793",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.