Active NPI
Diane Cantor Tenenbaum, M.D.
- Pediatrics Physician
- Albany, NY
National Provider Identifier
1962409409
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- 228318
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 02492322 | Medicaid | NY |
Other names 1
- Diane Rochelle Cantor
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
| License | State | Type | Specialty |
|---|---|---|---|
| 228318 | NY | MD | Pediatrics Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Schoolhouse Pediatrics South | Pediatrics | Past | Accepting new patients |
| Schoolhouse Road Pediatric, PC | Pediatrics | Past | Accepting new patients |
Interoperability endpoints
- schoolhousepediatrics.dianetenenbaum@160615.advancedmd-direct.com
- 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.
-
- Pediatrics Physician
- Albany, NY
- NPI 1932475951
-
- Pediatrics Physician
- Albany, NY
- NPI 1154428431
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.