Individual provider Active NPI

Tony Dicken, APN

  • Psychiatric/Mental Health Nurse Practitioner
  • Red Bank, NJ
National Provider Identifier
1124620364
Registry record updated Nov 12, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
26NJ01077300 Issued in NJ
Practice address
10 DRS James Parker Blvd Ste 105
Red Bank, NJ 07701-1500
Phone
(908) 433-7263
Fax
(732) 898-3559
NPI assigned
Nov 12, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 12, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 26NJ01077300 NJ Primary

Addresses

Primary practice location

10 DRS James Parker Blvd Ste 105
Red Bank, NJ 07701-1500

Mailing address

10 DRS James Parker Blvd Ste 105
Red Bank, NJ 07701-1500
Phone (908) 433-7263

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210303003266 NJ Practitioner - Nurse Practitioner 8527474220 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services
Group practices
Abby Road Psychiatric Services LLCGroup PAC ID 1658615638, 11 clinicians

Practice addresses (Care Compare)

7 Hendrickson Ave
Red Bank, NJ 07701-6122
Phone (732) 893-5316

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
26NJ01077300NJMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Abby Road Psychiatric Services LLC CurrentSince Dec 1, 2020 Accepting new patients

Locations

7 Hendrickson Ave
Red Bank, NJ 07701
Phone (732) 893-5314

10 Drs James Parker Blvd
Ste 105
Red Bank, NJ 07701
Phone (908) 433-7263

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.

NPI Registry JSON

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

{
    "created_epoch": "1605139200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1605139200000",
    "number": "1124620364",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10 DRS JAMES PARKER BLVD STE 105",
            "city": "RED BANK",
            "state": "NJ",
            "postal_code": "077011500",
            "telephone_number": "908-433-7263",
            "fax_number": "732-898-3559"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 DRS JAMES PARKER BLVD STE 105",
            "city": "RED BANK",
            "state": "NJ",
            "postal_code": "077011500",
            "telephone_number": "908-433-7263",
            "fax_number": "732-898-3559"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DICKEN",
        "first_name": "TONY",
        "credential": "APN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-11-12",
        "last_updated": "2020-11-12",
        "certification_date": "2020-11-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NJ",
            "license": "26NJ01077300",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Red Bank, NJ

Sources for this page

Verify at the official NPI Registry.