Active NPI 1043237779 Individual Practitioner Female Practitioner

Dr. Diane M Sixsmith , MD

Emergency Medicine • Flushing, NY

Professional Overview & Biography Verified Profile Summary

Dr. Diane Sixsmith, MD is a certified Emergency Medicine practicing in Flushing, NY. With approximately 53 years of clinical experience since graduating from University Of Pittsburgh School Of Medicine in 1973, Dr. Sixsmith delivers high-quality medical care to the local community at 56-45 MAIN ST.

Dr. Sixsmith is affiliated with Optum Urgent Care Pllc and does not directly accept Medicare assignment.

Frequently performed procedures and clinical services include established patient outpatient office visit, detection test by immunoassay with direct visual observation for severe acute respiratory syndrome coronavirus 2 (covid-19), new patient outpatient office visit. Full Medicare procedure pricing transparency rates and service volume details are listed on this profile.

Practice Location & Contact Primary Location

Practice Address

56-45 Main St
New York Hospital Medical Center Of Queens Emergency De

Flushing, NY 11355

Telephone 7186701231

Fax 5164374167

Associated Practice Facility / Clinic

🏢 Newyork-Presbyterian-Queens Facility NPI 1265478432

Medicare Profile & Education

Medical School

University Of Pittsburgh School Of Medicine

Graduation Year

1973

Medicare Assignment

Not Specified

Telehealth Flag

In-Person Only

Specialty Benchmarks & Practice Insights

Comparative analytics for Emergency Medicine in Flushing, NY

Senior Veteran Specialist (>20 Yrs)

Practitioner Clinical Experience

53 Yrs +39.4 yrs vs City Avg

City Avg: 13.6 Yrs

State Avg: 22.3 Yrs

Regional Practice Density

93 Specialists

Practicing in Flushing, NY (5148 Statewide)

Telehealth Adoption Rate

4.3% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount

75.0% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Clinical Seniority & Experience Comparison

Dr. Sixsmith (53 Years) 53 Yrs

Flushing Specialty Average (13.6 Years) 13.6 Yrs

Performed Procedures & Service Volume

Top Medicare Part B procedures performed by this practitioner

CMS Official Data (2024)

Reporting Year:

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99213 Established patient office or other outpatient visit, typically 15 minutes	140	112	$388.46	$96.38
87811 Detection test by immunoassay with direct visual observation for severe acute respiratory syndrome coronavirus 2 (covid-19)	76	68	$165.00	$40.55
99202 New patient office or other outpatient visit, typically 20 minutes	50	50	$340.00	$76.95
87428 Detection test by immunoassay technique for severe acute respiratory syndrome coronavirus and influenza	49	49	$195.41	$66.52
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	26	24	$265.00	$60.42
87880 Detection test by immunoassay with direct visual observation for streptococcus, group a (strep)	22	21	$62.27	$16.20
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	15	15	$540.00	$135.34
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	13	13	$483.46	$118.95
81003 Automated urinalysis test	11	11	$10.00	$2.20

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99213 Established patient office or other outpatient visit, typically 15 minutes	150	123	$293.20	$97.80
99202 New patient office or other outpatient visit, typically 20 minutes	79	79	$324.05	$78.87
87811 Detection test by immunoassay with direct visual observation for severe acute respiratory syndrome coronavirus 2 (covid-19)	55	47	$164.73	$40.55
87428 Detection test by immunoassay technique for severe acute respiratory syndrome coronavirus and influenza	40	39	$150.63	$30.32
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	32	30	$192.34	$61.58
87426 Detection test by immunoassay technique for severe acute respiratory syndrome coronavirus	25	25	$150.00	$34.62
81003 Automated urinalysis test	19	17	$9.47	$2.20
87880 Detection test by immunoassay with direct visual observation for streptococcus, group a (strep)	18	17	$50.00	$16.20
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	17	17	$412.94	$138.02
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	13	13	$392.69	$122.45

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99213 Established patient office or other outpatient visit, typically 15 minutes	216	190	$261.62	$100.74
87635 Amplifed dna or rna probe detection of severe acute respiratory syndrome coronavirus 2 (covid-19) antigen	118	106	$155.93	$50.76
87426 Detection test by immunoassay technique for severe acute respiratory syndrome coronavirus	99	93	$150.00	$34.85
99202 New patient office or other outpatient visit, typically 20 minutes	69	69	$270.00	$81.79
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	55	55	$385.00	$126.16
87804 Detection test by immunoassay with direct visual observation for influenza virus	36	18	$50.00	$16.28
87428 Detection test by immunoassay technique for severe acute respiratory syndrome coronavirus and influenza	25	25	$190.00	$30.34
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	12	12	$380.00	$141.82

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99213 Established patient office or other outpatient visit, typically 15 minutes	533	420	$184.87	$107.03
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	99	99	$279.25	$130.67
36415 Insertion of needle into vein for collection of blood sample	54	52	$41.28	$3.00
87426 Detection test by immunoassay technique for severe acute respiratory syndrome coronavirus	48	46	$150.00	$35.33
0012A Adm sarscov2 100mcg/0.5ml2nd	46	46	$50.43	$35.97
81002 Urinalysis, manual test	39	36	$50.00	$3.48
0011A Adm sarscov2 100mcg/0.5ml1st	30	30	$50.00	$22.20
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	19	18	$260.01	$145.92
87635 Amplifed dna or rna probe detection of severe acute respiratory syndrome coronavirus 2 (covid-19) antigen	16	15	$250.00	$51.31
99202 New patient office or other outpatient visit, typically 20 minutes	15	15	$270.00	$82.80
87880 Detection test by immunoassay with direct visual observation for streptococcus, group a (strep)	13	13	$50.00	$16.53

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99213 Established patient office or other outpatient visit, typically 15 minutes	477	390	$123.06	$86.38
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	228	228	$190.09	$125.27
36415 Insertion of needle into vein for collection of blood sample	211	197	$27.09	$2.99
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	119	110	$155.26	$122.80
G0008 Administration of influenza virus vaccine	83	83	$47.41	$19.63
90662 Influenza vaccine split virus, preservative free	75	75	$99.00	$60.98
81002 Urinalysis, manual test	53	51	$27.36	$3.45
87804 Detection test by immunoassay with direct visual observation for influenza virus	48	23	$31.67	$16.22
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	44	44	$225.23	$188.38
71046 X-ray of chest, 2 views	20	19	$37.51	$37.15
82962 Blood glucose (sugar) test performed by hand-held instrument	19	19	$23.16	$3.24
87880 Detection test by immunoassay with direct visual observation for streptococcus, group a (strep)	18	18	$27.78	$16.33
87426 Detection test by immunoassay technique for severe acute respiratory syndrome coronavirus	18	18	$150.00	$35.33
93000 Routine ekg using at least 12 leads including interpretation and report	13	13	$27.81	$19.93

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99213 Established patient office or other outpatient visit, typically 15 minutes	241	201	$126.72	$83.03
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	85	82	$170.43	$119.85
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	58	58	$205.11	$122.32
87804 Detection test by immunoassay with direct visual observation for influenza virus	52	26	$38.08	$15.00
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	42	42	$282.20	$184.46
G0008 Administration of influenza virus vaccine	35	35	$42.12	$18.97
81002 Urinalysis, manual test	33	28	$25.00	$3.41
87880 Detection test by immunoassay with direct visual observation for streptococcus, group a (strep)	28	28	$30.71	$16.20
36415 Insertion of needle into vein for collection of blood sample	22	19	$28.41	$2.94
J7613 Albuterol, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose, 1 mg	19	11	$21.84	$0.04
94010 Test to measure expiratory airflow and volume	18	18	$42.06	$41.39
90662 Influenza vaccine split virus, preservative free	18	18	$100.00	$54.89
81003 Automated urinalysis test	15	14	$11.53	$2.44
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	13	11	$68.86	$51.36
71046 X-ray of chest, 2 views	12	12	$37.15	$36.56
90686 Vaccine for influenza for administration into muscle, 0.5 ml dosage	11	11	$100.00	$18.65

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99213 Established patient office or other outpatient visit, typically 15 minutes	157	124	$200.64	$77.95
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	56	56	$300.00	$116.87
87804 Detection test by immunoassay with direct visual observation for influenza virus	28	14	$45.00	$16.22
81003 Automated urinalysis test	20	20	$12.00	$2.71
87880 Detection test by immunoassay with direct visual observation for streptococcus, group a (strep)	18	17	$40.00	$16.20
99211 Office or other outpatient visit for the evaluation and management of established patient that may not require presence of healthcare professional	14	14	$75.00	$23.31

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99213 Established patient office or other outpatient visit, typically 15 minutes	128	103	$200.00	$78.64
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	72	72	$300.00	$118.42
87804 Detection test by immunoassay with direct visual observation for influenza virus	24	12	$45.00	$11.75
81003 Automated urinalysis test	13	11	$12.00	$3.02
87880 Detection test by immunoassay with direct visual observation for streptococcus, group a (strep)	12	11	$40.00	$11.75

Medical Specialties & State Licenses

Emergency Medicine Primary Specialty

NUCC Taxonomy Code: 207P00000X

State License NY 122203

An emergency physician focuses on the immediate decision making and action necessary to prevent death or any further disability both in the pre-hospital setting by directing emergency medical technicians and in the emergency department. The emergency physician provides immediate recognition, evaluation, care, stabilization and disposition of a generally diversified population of adult and pediatric patients in response to acute illness and injury.

Additional State Medicaid & Healthcare Payer Identifiers

Medicaid State Provider ID

00229896 (NY)

Hospital & Practice Group Affiliations

Optum Urgent Care Pllc

254 -21 Nassau Blvd, Little Neck, NY 11362

Phone: 9175631660

Practice Associates & Co-Workers

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

40 Associated Practitioners

Louise Merriman , RD

Nutritionist

NPI 1003011586

Registered Dietitian

Ana Ghelechkhani , PA

Physician Assistant - Medical

NPI 1003050782

Physician Assistant

Lee Anne Robison , MA

Speech-Language Pathologist

NPI 1013009877

Master of Arts

Sona Fenko , PA

Physician Assistant - Surgical

NPI 1013065689

Physician Assistant

Dr. Efthemia Nicolopoulos , MD

Pediatrics

NPI 1023147394

Doctor of Medicine (M.D.)

Mary Webb , RD

Dietitian, Registered

NPI 1023178928

Registered Dietitian

Career & Practice History Timeline

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

6 Historical Events

✅

NPI Profile Active November 02, 2010

NPI status registered as active in NPPES database

📍

Updated Practice Location November 02, 2010

Registered at 56-45 MAIN ST, NEW YORK HOSPITAL MEDICAL CENTER OF QUEENS EMERGENCY DE, FLUSHING, NY 11355 (Tel: 7186701231)

📍

Updated Business Mailing Address November 02, 2010

Registered at 1981 MARCUS AVE, SUITE 208, NEW HYDE PARK, NY 110421038 (Tel: 7186701651)

👤

Provider Name / Credentials Updated November 02, 2010

Recorded as DIANE SIXSMITH, MD

🎓

Medical Taxonomy / Specialty Registered (Primary Specialty) November 02, 2010

Emergency Medicine (License #122203 in NY)

🟢

Initial NPI Registration & Enumeration July 17, 2006

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

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NPI Administrative Meta

NPI Number: 1043237779

Entity Type:

Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)

Enumeration Date: July 17, 2006

Last Update: November 02, 2010

Sole Proprietor: No

Update or Correct Profile

Mailing Address

1981 Marcus Ave, Suite 208

New Hyde Park, NY 110421038

Phone: 7186701651

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.