Individual provider Active NPI

Dianne Costanzo, MSED SAS

  • Specialist
  • Pond Eddy, NY
National Provider Identifier
1962176255
Registry record updated Aug 2, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
Practice address
2661 Route 97
Pond Eddy, NY 10528
Phone
(914) 708-6294
NPI assigned
Aug 2, 2021
Last updated
Aug 2, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 2, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 941190991 NY
Specialist 174400000X NU Primary

Addresses

Primary practice location

2661 Route 97
Pond Eddy, NY 10528

Mailing address

15 Tamarac TRL
Harrison, NY 10528-1817
Phone (914) 708-6294

Other identifiers 1

IdentifierTypeStateIssuer
941190991OtherNYSPECIAL EDUCATION

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL diannene3@gmail.com Health Information Exchange (HIE)

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
941190991NYMDSpecialist

NPI Registry JSON

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

{
    "created_epoch": "1627862400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1627862400000",
    "number": "1962176255",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15 TAMARAC TRL",
            "city": "HARRISON",
            "state": "NY",
            "postal_code": "105281817",
            "telephone_number": "914-708-6294"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2661 ROUTE 97",
            "city": "POND EDDY",
            "state": "NY",
            "postal_code": "10528",
            "telephone_number": "914-708-6294"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COSTANZO",
        "first_name": "DIANNE",
        "name_prefix": "Ms.",
        "credential": "MSED SAS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-08-02",
        "last_updated": "2021-08-02",
        "certification_date": "2021-07-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NY",
            "license": "941190991",
            "primary": false
        },
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SPECIAL EDUCATION",
            "identifier": "941190991",
            "state": "NY"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "diannene3@gmail.com",
            "affiliation": "N",
            "endpointDescription": "email",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "15 Tamarac Trl",
            "city": "Harrison",
            "state": "NY",
            "country_code": "US",
            "postal_code": "105281817",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 2, 2021; 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.