Active NPI
Breeana Dickson
- Nurse Practitioner
- Hackensack, NJ
National Provider Identifier
1003630468
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse Practitioner
- License
- 26NJ15187700
- Practice address
- 2 University PLZ Ste 204
Hackensack, NJ 07601-6211 - Phone
- (973) 435-9463
- NPI assigned
- Nov 12, 2024
- 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 |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | 26NJ15187700 | NJ | Primary |
Addresses
Primary practice location
2 University PLZ Ste 204
Hackensack, NJ 07601-6211
Mailing address
4 James CT
West Orange, NJ 07052-6201
Phone (973) 725-7091
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NJ
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Nurse Practitioner
- Education
- Other, 2024
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
56 Georgetown Rd
Bordentown, NJ 08505-2405
Phone (609) 227-2400
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 26NJ15187700 | NJ | MD | Nurse Practitioner |
Organizations & group practices 4
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.
-
- Hospice and Palliative Medicine (Emergency Medicine) Physician
- Bordentown, NJ
- NPI 1902621097
-
- Geriatric Medicine (Family Medicine) Physician
- Hackensack, NJ
- NPI 1871475806
-
- Geriatric Medicine (Family Medicine) Physician
- Hackensack, NJ
- NPI 1043192099
-
- Geriatric Medicine (Family Medicine) Physician
- Hackensack, NJ
- NPI 1306500764
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1731369600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1731369600000",
"number": "1003630468",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4 JAMES CT",
"city": "WEST ORANGE",
"state": "NJ",
"postal_code": "070526201",
"telephone_number": "973-725-7091"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2 UNIVERSITY PLZ STE 204",
"city": "HACKENSACK",
"state": "NJ",
"postal_code": "076016211",
"telephone_number": "973-435-9463"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DICKSON",
"first_name": "BREEANA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2024-11-12",
"last_updated": "2024-11-12",
"certification_date": "2024-11-12",
"status": "A"
},
"taxonomies": [
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "NJ",
"license": "26NJ15187700",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Hackensack, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 12, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.