Individual provider Active NPI

Nereida Diaz-Johnson, M.D.

  • Internal Medicine Physician
  • Union, NJ
National Provider Identifier
1013939917
Registry record updated Mar 31, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
MA49304 Issued in NJ
Practice address
2401 Morris Ave
Union, NJ 07083-5745
Phone
(908) 688-5000
Fax
(908) 688-5220
NPI assigned
Jul 23, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 31, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X MA49304 NJ Primary

Addresses

Primary practice location

2401 Morris Ave
Union, NJ 07083-5745

Mailing address

2401 Morris Ave
Union, NJ 07083-5745
Phone (908) 688-5000

Other identifiers 2

IdentifierTypeStateIssuer
0256404MedicaidNJ
571147408OtherNJEMPLOYER IDENTIFIER NUMBER/TAX IDENTIFICATION NUMBER

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20051010000432 NJ Practitioner - Internal Medicine 9931124963 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1985
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Union Medical Group, LLCGroup PAC ID 7719175694, 2 clinicians

Practice addresses (Care Compare)

2333 Morris Ave
Suite A109
Union, NJ 07083-5715
Phone (908) 688-5000

Hospital & facility affiliations

  • Atlantic Visiting Nurse Home health agency, Morristown, NJ, CCN 317054
  • Overlook Medical Center Hospital, Summit, NJ, CCN 310051

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MA49304NJMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Union Medical Group, LLC Internal Medicine CurrentSince Jan 1, 2000 Accepting new patients

Locations

2333 Morris Ave
Ste A109
Union, NJ 07083
Phone (908) 688-5000

2401 Morris Ave
Union, NJ 07083
Phone (908) 688-5000

Interoperability endpoints

  • Direct secure messaging: nereida.johnson@direct.digidms.com

Organizations & group practices 1

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1153612800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1269993600000",
    "number": "1013939917",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2401 MORRIS AVE",
            "city": "UNION",
            "state": "NJ",
            "postal_code": "070835745",
            "telephone_number": "908-688-5000",
            "fax_number": "908-688-5220"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2401 MORRIS AVE",
            "city": "UNION",
            "state": "NJ",
            "postal_code": "070835745",
            "telephone_number": "908-688-5000",
            "fax_number": "908-688-5220"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIAZ-JOHNSON",
        "first_name": "NEREIDA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-23",
        "last_updated": "2010-03-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NJ",
            "license": "MA49304",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0256404",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "EMPLOYER IDENTIFIER NUMBER/TAX IDENTIFICATION NUMBER",
            "identifier": "571147408",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Union, NJ

Sources for this page

Verify at the official NPI Registry.