Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Dr. Diane Iragena Shumbusho, MD

Individual provider Obstetrics & Gynecology Physician · NPI 1457708802

Dr. Diane Iragena Shumbusho, MD is an Obstetrics/Gynecology in Watertown, New York. Qualified in 2016, 10 years ago. Practices with Samaritan Medical Center, a 158-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in New York and Virginia.

Years since qualifying
10
Licensed in
NY, VA
In the registry since
2016
Specialties on file
2
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

1575 Washington St
Watertown, NY 13601-9371
Phone: (315) 785-4155
Fax: (315) 779-5066
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 11050 Mount Belvedere Blvd, Fort Drum, NY 13602-5438 — (315) 779-5385

Specialties & licences

Obstetrics & Gynecology Physician (primary) Taxonomy 207V00000X · Licence 328335 (NY)
Obstetrics & Gynecology Physician Taxonomy 207V00000X · Licence 0101264178 (VA)

Record details

NPI number1457708802
Entity typeIndividual (Type 1)
GenderFemale
Credentials MD
Sole proprietorNo
NPI enumeratedMay 16, 2016
Last updated in NPPESApril 17, 2024
Certification dateMay 13, 2022

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyOBSTETRICS/GYNECOLOGY
Medical schoolOTHER
Graduated 2016 (10 years in practice)
Group practice Samaritan Medical Center — 158 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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