Independent US Healthcare Provider Directory & Public Medical Database
Active NPI 1124082375 Individual Practitioner Female Practitioner

Dr. Diane A Bourke , MD

Pediatrics - Developmental - Behavioral Pediatrics • Latham, NY

Professional Overview & Biography Verified Profile Summary

Dr. Diane Bourke, MD is a registered healthcare professional specializing in Pediatrics - Developmental - Behavioral Pediatrics in Latham, NY. Practice services are available at 7B JOHNSON RD under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

7b Johnson Rd

Latham, NY 121103003

Telephone 5187827733
Fax 5187820800
Associated Practice Facility / Clinic

Specialty Benchmarks & Practice Insights

Comparative analytics for Pediatrics - Developmental - Behavioral Pediatrics in Latham, NY

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 25.3 Yrs
Regional Practice Density
5 Specialists

Practicing in Latham, NY (112 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

Pediatrics - Developmental - Behavioral Pediatrics Primary Specialty

NUCC Taxonomy Code: 2080P0006X

State License NY 173530

A developmental-behavioral specialist is a pediatrician with special training and experience who aims to foster understanding and promotion of optimal development of children and families through research, education, clinical care and advocacy efforts. This physician assists in the prevention, diagnosis, and management of developmental difficulties and problematic behaviors in children and in the family dysfunctions that compromise children's development.

Specialist

NUCC Taxonomy Code: 174400000X

State License NY 173530

An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.

Additional State Medicaid & Healthcare Payer Identifiers

Medicaid State Provider ID
01820997 (NY)
Commercial Insurance / Payer ID Ghi/hmo
143257 (NY)
Commercial Insurance / Payer ID Aetna
5780670 (NY)
Commercial Insurance / Payer ID Empire Bluecross
042ZE1 (NY)
Commercial Insurance / Payer ID Fidelis
091231000203 (NY)
Commercial Insurance / Payer ID Cdphp
PRC110027743 (NY)
Commercial Insurance / Payer ID Mvp Helathcare
9042526 (NY)

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

17 Associated Practitioners
Dr. Anthony Malone , MD

Pediatrics - Developmental - Behavioral Pediatrics

NPI 1033172952

Doctor of Medicine (M.D.)

James Roth , MPH, FNP

Nurse Practitioner - Family

NPI 1053967992

Master of Public Health, Family Nurse Practitioner

April St. Peter , FNP

Nurse Practitioner - Family

NPI 1063987915

Family Nurse Practitioner

NPI 1114179256

Registered Nurse

NPI 1124266606

Registered Nurse

Bridget Carnivale , FNP-BC

Nurse Practitioner - Family

NPI 1184505075

Family Nurse Practitioner (Board Certified)

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

12 Historical Events
NPI Profile Active January 18, 2018

NPI status registered as active in NPPES database

📍
Updated Business Mailing Address January 18, 2018

Registered at 711 TROY SCHENECTADY RD STE 203, LATHAM, NY 121102461 (Tel: 5187823700)

📍
Updated Practice Location January 18, 2018

Registered at 7B JOHNSON RD, LATHAM, NY 121103003 (Tel: 5187827733)

👤
Provider Name / Credentials Updated January 18, 2018

Recorded as DIANE BOURKE, M.D.

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) January 18, 2018

Pediatrics (License #173530 in NY)

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) January 18, 2018

Specialist (License #173530 in NY)

NPI Profile Active March 25, 2010

NPI status registered as active in NPPES database

📍
Updated Practice Location March 25, 2010

Registered at 7B JOHNSON RD, LATHAM, NY 121103003 (Tel: 5187827733)

📍
Updated Business Mailing Address March 25, 2010

Registered at 7B JOHNSON RD, LATHAM, NY 121103003 (Tel: 5187827733)

👤
Provider Name / Credentials Updated March 25, 2010

Recorded as DIANE BOURKE, M.D.

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) March 25, 2010

Specialist (License #173530 in NY)

🟢
Initial NPI Registration & Enumeration April 14, 2006

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1124082375
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: April 14, 2006
Last Update: January 18, 2018
Sole Proprietor: No

Mailing Address

711 Troy Schenectady Rd Ste 203

Latham, NY 121102461

Phone: 5187823700

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.