Individual provider Active NPI

CHI-Ying Diana Sage, ARNP

  • Family Nurse Practitioner
  • Waterloo, IA
National Provider Identifier
1831722370
Registry record updated May 14, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
A157738 Issued in IA
Practice address
1753 W Ridgeway Ave Ste 103a
Waterloo, IA 50701-4521
Phone
(319) 235-3568
Fax
(319) 235-5013
NPI assigned
Feb 12, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 14, 2020

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 A157738 IA Primary

Addresses

Primary practice location

1753 W Ridgeway Ave Ste 103a
Waterloo, IA 50701-4521

Mailing address

PO Box 2818
Waterloo, IA 50704-2818
Phone (319) 235-3568

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA
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
I20200416002626 IA Practitioner - Nurse Practitioner 4082044995 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Matthew Smith MD PCGroup PAC ID 8022402411, 2 clinicians

Practice addresses (Care Compare)

1753 W Ridgeway Ave
Suite 103a
Waterloo, IA 50701-4521
Phone (319) 235-3568

Hospital & facility affiliations

  • Allen Hospital Hospital, Waterloo, IA, CCN 160110

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Matthew Smith MD PC CurrentSince Jan 1, 2022 Accepting new patients
St Luke'S Methodist Hospital Current Accepting new patients
Matthew J Smith PastSince Mar 1, 2020 Accepting new patients

Locations

1753 W Ridgeway Ave
Ste 103A
Waterloo, IA 50701
Phone (319) 235-3568

Interoperability endpoints

  • Direct secure messaging: csage777200@direct.unitypoint.org

Organizations & group practices 4

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 1

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": "1581465600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1589414400000",
    "number": "1831722370",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2818",
            "city": "WATERLOO",
            "state": "IA",
            "postal_code": "507042818",
            "telephone_number": "319-235-3568",
            "fax_number": "319-235-5013"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1753 W RIDGEWAY AVE STE 103A",
            "city": "WATERLOO",
            "state": "IA",
            "postal_code": "507014521",
            "telephone_number": "319-235-3568",
            "fax_number": "319-235-5013"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SAGE",
        "first_name": "CHI-YING",
        "middle_name": "DIANA",
        "name_prefix": "Mrs.",
        "credential": "ARNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-02-12",
        "last_updated": "2020-05-14",
        "certification_date": "2020-05-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IA",
            "license": "A157738",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Waterloo, IA

Sources for this page

Verify at the official NPI Registry.