Individual provider Active NPI

Wadih Diab, MD

  • Surgery Physician
  • Johnson City, NY
National Provider Identifier
1972597284
Registry record updated Nov 18, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
141000 Issued in NY
Practice address
30 Harrison St
Johnson City, NY 13790-2161
Phone
(607) 763-8100
Fax
(607) 763-8048
NPI assigned
Sep 1, 2005
Last updated
Nov 18, 2011By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 18, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 141000 NY Primary

Addresses

Primary practice location

30 Harrison St
Johnson City, NY 13790-2161

Mailing address

346 Grand Ave
Johnson City, NY 13790-2558
Phone (607) 729-8156

Other identifiers 1

IdentifierTypeStateIssuer
00645547MedicaidNY

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
I20100217000566 NY Practitioner - General Surgery 7517001324 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
89.14 of 100Reported as group
Quality
86.74
Promoting interoperability
99
Improvement activities
40
Cost
70.09

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
141000NYMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
United Medical Associates PC CurrentSince Mar 11, 2000 Accepting new patients
United Medical Associates, P.C. CurrentSince Mar 11, 2000 Accepting new patients

Locations

91 Chenango Bridge Rd
Binghamton, NY 13901
Phone (607) 648-4151

33 Lewis Rd
Fl 2
Binghamton, NY 13905
Phone (607) 729-8156

10-42 Mitchell Ave
Binghamton, NY 13903
Phone (607) 762-2468

346 Grand Ave
Johnson City, NY 13790
Phone (607) 729-8156

30 Harrison St
Ste 455
Johnson City, NY 13790
Phone (607) 763-8100

33-57 Harrison St
Johnson City, NY 13790
Phone (607) 763-6412

Organizations & group practices 3

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": "1125532800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1321574400000",
    "number": "1972597284",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "346 GRAND AVE",
            "city": "JOHNSON CITY",
            "state": "NY",
            "postal_code": "137902558",
            "telephone_number": "607-729-8156",
            "fax_number": "607-729-2209"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30 HARRISON ST",
            "city": "JOHNSON CITY",
            "state": "NY",
            "postal_code": "137902161",
            "telephone_number": "607-763-8100",
            "fax_number": "607-763-8048"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIAB",
        "first_name": "WADIH",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-01",
        "last_updated": "2011-11-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "NY",
            "license": "141000",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00645547",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Johnson City, NY

Sources for this page

Verify at the official NPI Registry.