Dka Medical LLC

Primary specialty

Primary Care Nurse PractitionerTaxonomy code 363LP2300X

Legal business name

DKA MEDICAL LLC

Practice address

4 Walnut Ter
East Hanover, NJ 07936-3063

Phone

(973) 641-0353

Fax

(973) 857-1240

NPI assigned

Nov 21, 2022

Organization subpart

No

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

Authorized official

Name

Andre Augustin, NPNPI 1376291013

Title

NP

Phone

(973) 641-0353

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NJ

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Andre Augustin, APN

  • Gerontology Nurse Practitioner
  • Bloomfield, NJ
  • NPI 1376291013

  Nursing Care

  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1668988800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1701820800000",
    "number": "1124737093",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4 WALNUT TER",
            "city": "EAST HANOVER",
            "state": "NJ",
            "postal_code": "079363063",
            "telephone_number": "973-641-0353",
            "fax_number": "973-857-1240"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4 WALNUT TER",
            "city": "EAST HANOVER",
            "state": "NJ",
            "postal_code": "079363063",
            "telephone_number": "973-641-0353",
            "fax_number": "973-857-1240"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DKA MEDICAL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-11-21",
        "last_updated": "2023-12-06",
        "certification_date": "2023-12-06",
        "status": "A",
        "authorized_official_last_name": "AUGUSTIN",
        "authorized_official_first_name": "ANDRE",
        "authorized_official_title_or_position": "NP",
        "authorized_official_telephone_number": "973-641-0353",
        "authorized_official_credential": "NP"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mark Anthony Diehl, PA-C
• Michael D Difazio, DC
• Muhammadali Iqbal Dinani, DMD
• Lauren S Ditaranto, LPC
• Jane Vanacore Dixon, RDN, CDCES
• Michele Bauzil Dolisca, NP
• William Domke II
• Mary Theresa Downey-Freiman, RN MSN OCN
• Dr. Joseph L. Cavallo, OD
• Nicholas Dugan

• Primary Care Nurse Practitioner in East Hanover, NJ
• Providers in East Hanover, NJ by specialty
• Primary Care Nurse Practitioner in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 6, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.