Individual provider Active NPI

Diana Nido, M.D.

  • Internal Medicine Physician
  • Huntington, NY
National Provider Identifier
1891119749
Registry record updated Jan 10, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
290076 Issued in NY
Practice address
775 Park Ave Ste 145
Huntington, NY 11743-7513
Phone
(631) 261-4445
NPI assigned
Feb 13, 2014
Last updated
Jan 10, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 10, 2024

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 290076 NY Primary

Addresses

Primary practice location

775 Park Ave Ste 145
Huntington, NY 11743-7513

Mailing address

775 Park Ave Ste 145
Huntington, NY 11743-7513
Phone (631) 261-4445

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
I20170821001705 NY Practitioner - Internal Medicine 4486926821 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
290076NYMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Internal Medicine Associates, PC Internal Medicine CurrentSince Sep 20, 2021 Accepting new patients
Stony Brook Internists, University Faculty Practice Corporation CurrentSince Aug 1, 2017 Accepting new patients
Internal Medicine Associates, PC Internal Medicine CurrentSince Sep 20, 2021 Accepting new patients
Stony Brook Internists, University Faculty Practice Corporation Internal Medicine CurrentSince Aug 1, 2017 Accepting new patients

Locations

25710 Union Tpke
Glen Oaks, NY 11004
Phone (718) 343-7200

200 Motor Pkwy
Ste C14
Hauppauge, NY 11788
Phone (631) 265-9355

775 Park Ave
Ste 145
Huntington, NY 11743
Phone (631) 261-4445

5499 Route 347
Mount Sinai, NY 11766
Phone (631) 331-3910

21422 73rd Ave
Oakland Gdns, NY 11364
Phone (718) 347-3500

205 N Belle Mead Rd
Setauket, NY 11733
Phone (631) 444-1660

100 Nicolls Rd
Stony Brook, NY 11794
Phone (631) 444-1560

100 Nicolls Rd
#13202
Stony Brook, NY 11794

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1392249600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1704844800000",
    "number": "1891119749",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "775 PARK AVE STE 145",
            "city": "HUNTINGTON",
            "state": "NY",
            "postal_code": "117437513",
            "telephone_number": "631-261-4445"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "775 PARK AVE STE 145",
            "city": "HUNTINGTON",
            "state": "NY",
            "postal_code": "117437513",
            "telephone_number": "631-261-4445"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NIDO",
        "first_name": "DIANA",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-02-13",
        "last_updated": "2024-01-10",
        "certification_date": "2024-01-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "290076",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Huntington, NY

Sources for this page

Verify at the official NPI Registry.