Diane Goldberg Tanenbaum, MD

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

095197 Issued in NY

Practice address

16 E 79TH St
Suite 22
New York, NY 10075-0150

Phone

(212) 249-6122

Fax

(212) 249-7838

NPI assigned

Aug 4, 2006

Last updated

Jul 20, 2010By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Specialty

Dermatology

Education

State University of New York Downstate Medical Center, 1964

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1154649600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1279584000000",
    "number": "1821006818",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16 E 79TH ST",
            "address_2": "SUITE 22",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100750150",
            "telephone_number": "212-249-6122",
            "fax_number": "212-249-7838"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16 E 79TH ST",
            "address_2": "SUITE 22",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100750150",
            "telephone_number": "212-249-6122",
            "fax_number": "212-249-7838"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TANENBAUM",
        "first_name": "DIANE",
        "middle_name": "GOLDBERG",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-04",
        "last_updated": "2010-07-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "NY",
            "license": "095197",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sanjeev Roy Taneja, M.D
• Anthony John Tanella
• David Zachary Tanen, DMD
• Judith Anne Tanen
• Shira Tanen, LCSW
• Donald R Tanenbaum, DDS
• Jennifer Lee Tanenbaum, M.S. CCC-SLP
• Jessica Sophie Tanenbaum, MD
• Judith Hertz Tanenbaum, MD
• Lawrence Neil Tanenbaum, M.D.

• Dermatology Physician in New York, NY
• Providers in New York, NY by specialty
• Dermatology Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 20, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.