Individual provider Active NPI

Diane Cantor Tenenbaum, M.D.

  • Pediatrics Physician
  • Albany, NY
National Provider Identifier
1962409409
Registry record updated Aug 8, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
228318 Issued in NY
Practice address
1092 Madison Ave
Albany, NY 12208-2248
Phone
(518) 525-2445
Fax
(518) 475-7069
NPI assigned
Jun 30, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 8, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 228318 NY Primary

Addresses

Primary practice location

1092 Madison Ave
Albany, NY 12208-2248

Mailing address

1092 Madison Ave
Albany, NY 12208-2248
Phone (518) 525-2445

Other identifiers 1

IdentifierTypeStateIssuer
02492322MedicaidNY

Other names 1

  • Diane Rochelle Cantor Former name

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)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
228318NYMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Schoolhouse Pediatrics South Pediatrics Past Accepting new patients
Schoolhouse Road Pediatric, PC Pediatrics Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: schoolhousepediatrics.dianetenenbaum@160615.advancedmd-direct.com
  • Direct secure messaging: dtenenbaum4417013@direct.trinity-health.org

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": "1120089600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1375920000000",
    "number": "1962409409",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1092 MADISON AVE",
            "city": "ALBANY",
            "state": "NY",
            "postal_code": "122082248",
            "telephone_number": "518-525-2445",
            "fax_number": "518-475-7069"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1092 MADISON AVE",
            "city": "ALBANY",
            "state": "NY",
            "postal_code": "122082248",
            "telephone_number": "518-525-2445",
            "fax_number": "518-475-7069"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TENENBAUM",
        "first_name": "DIANE",
        "middle_name": "CANTOR",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-06-30",
        "last_updated": "2013-08-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NY",
            "license": "228318",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02492322",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DIANE",
            "last_name": "CANTOR",
            "middle_name": "ROCHELLE",
            "credential": "M.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Albany, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 8, 2013; 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.