Individual provider Active NPI

Diana Riccioli, M.D.

  • Psychiatry Physician
  • Clifton, NJ
National Provider Identifier
1073631081
Registry record updated Jun 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
25MA06190800 Issued in NJ
Practice address
925 Clifton Ave
Ste 103
Clifton, NJ 07013-2724
Phone
(973) 417-5256
Fax
(973) 471-5157
NPI assigned
Mar 27, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 21, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Behavioral Neurology & Neuropsychiatry PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2084B0040X MA61908 NJ
Psychiatry Physician 2084P0800X 25MA06190800 NJ Primary

Addresses

Primary practice location

925 Clifton Ave
Ste 103
Clifton, NJ 07013-2724

Mailing address

230 E Ridgewood Ave
Paramus, NJ 07652-4142
Phone (201) 967-4000

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
I20040908001581 NJ Practitioner - Psychiatry 5799751970 Reassigns benefits to 1 organization
Practice locations: Clifton, NJ

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Other, 1988
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services
Group practices
Care Plus NJ IncGroup PAC ID 9436160553, 52 clinicians

Practice addresses (Care Compare)

610 Valley Health Plaza
Paramus, NJ 07652-3607

610 Valley Health PLZ
Paramus, NJ 07652-3607
Phone (201) 265-8200

925 Clifton Ave
Suite 103
Clifton, NJ 07013-2724
Phone (973) 471-5256

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MA61908NJMDBehavioral Neurology & Neuropsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Care Plus NJ, Inc. Single Specialty Current Accepting new patients
Care Plus New Jersey, Inc. CurrentSince Jul 31, 2018 Accepting new patients

Locations

610 Valley Health Plz
Paramus, NJ 07652
Phone (201) 797-2660

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1174953600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1655769600000",
    "number": "1073631081",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "230 E RIDGEWOOD AVE",
            "city": "PARAMUS",
            "state": "NJ",
            "postal_code": "076524142",
            "telephone_number": "201-967-4000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "925 CLIFTON AVE",
            "address_2": "STE 103",
            "city": "CLIFTON",
            "state": "NJ",
            "postal_code": "070132724",
            "telephone_number": "973-417-5256",
            "fax_number": "973-471-5157"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RICCIOLI",
        "first_name": "DIANA",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-03-27",
        "last_updated": "2022-06-21",
        "certification_date": "2022-06-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084B0040X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Behavioral Neurology & Neuropsychiatry",
            "state": "NJ",
            "license": "MA61908",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NJ",
            "license": "25MA06190800",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clifton, NJ

Sources for this page

Verify at the official NPI Registry.