Individual provider Active NPI

Diana Pak

  • Family Nurse Practitioner
  • Glendale, NY
National Provider Identifier
1760332274
Registry record updated May 27, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
F358904 Issued in NY
Practice address
6829 Myrtle Ave
Glendale, NY 11385-7234
Phone
(718) 821-4424
NPI assigned
Feb 3, 2026
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 27, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X F358904 NY Primary

Addresses

Primary practice location

6829 Myrtle Ave
Glendale, NY 11385-7234

Mailing address

6829 Myrtle Ave
Glendale, NY 11385-7234
Phone (718) 821-4424

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
I20260609001347 NY Practitioner - Nurse Practitioner 7719458900 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2026
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

13818 28TH Rd
Apt 2B
Flushing, NY 11354-1835

13818 28TH Rd Apt
2B
Flushing, NY 11354-1836

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
F358904NYMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Prominis Medical Services PC CurrentSince Oct 23, 2004 Accepting new patients
Comprehensive Women'S Health of N.Y. PLLC PastSince Jan 9, 2009 Accepting new patients

Locations

37 5th Ave
Brooklyn, NY 11217
Phone (347) 987-3966

6570 Myrtle Ave
Glendale, NY 11385
Phone (718) 366-5391

6829 Myrtle Ave
Glendale, NY 11385
Phone (718) 366-2242

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.

NPI Registry JSON

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

{
    "created_epoch": "1770076800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1779840000000",
    "number": "1760332274",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6829 MYRTLE AVE",
            "city": "GLENDALE",
            "state": "NY",
            "postal_code": "113857234",
            "telephone_number": "718-821-4424"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6829 MYRTLE AVE",
            "city": "GLENDALE",
            "state": "NY",
            "postal_code": "113857234",
            "telephone_number": "718-821-4424"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PAK",
        "first_name": "DIANA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2026-02-03",
        "last_updated": "2026-05-27",
        "certification_date": "2026-05-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "F358904",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glendale, NY

Sources for this page

Verify at the official NPI Registry.