Individual provider Active NPI

Natasha Dillon, NP

  • Psychiatric/Mental Health Nurse Practitioner
  • Wayne, NJ
National Provider Identifier
1174296883
Registry record updated Jul 28, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
26NJ01179400 Issued in NJ
Practice address
401 Hamburg Tpke Ste 302
Wayne, NJ 07470-2139
Phone
(973) 790-9222
NPI assigned
Jul 28, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 28, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 403552 NY
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 26NJ01179400 NJ Primary

Addresses

Primary practice location

401 Hamburg Tpke Ste 302
Wayne, NJ 07470-2139

Mailing address

392 Grand Ave Apt 7
Leonia, NJ 07605-2215
Phone (201) 475-0022

Electronic endpoints 1

TypeEndpointUseAffiliation
SOAP URL Leonia Direct

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
I20210907000671 NJ Practitioner - Nurse Practitioner 7315343068 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Wayne Behavioral Service LLCGroup PAC ID 8820097561, 34 clinicians

Practice addresses (Care Compare)

401 Hamburg Tpke
Suite 302
Wayne, NJ 07470-2139
Phone (973) 790-9222

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
26NJ01179400NJMDPsychiatric/Mental Health Nurse Practitioner
403552NYMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Wayne Behavioral Service, LLC CurrentSince Sep 13, 2021 Accepting new patients

Locations

401 Hamburg Tpke
Ste 302
Wayne, NJ 07470
Phone (973) 790-9222

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": "1627430400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1627430400000",
    "number": "1174296883",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "392 GRAND AVE APT 7",
            "city": "LEONIA",
            "state": "NJ",
            "postal_code": "076052215",
            "telephone_number": "201-475-0022"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 HAMBURG TPKE STE 302",
            "city": "WAYNE",
            "state": "NJ",
            "postal_code": "074702139",
            "telephone_number": "973-790-9222"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DILLON",
        "first_name": "NATASHA",
        "name_prefix": "Ms.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-07-28",
        "last_updated": "2021-07-28",
        "certification_date": "2021-05-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NY",
            "license": "403552",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NJ",
            "license": "26NJ01179400",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "Leonia",
            "affiliation": "N",
            "endpointDescription": "laptop",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "392 Grand Ave Apt 7",
            "city": "Leonia",
            "state": "NJ",
            "country_code": "US",
            "postal_code": "076052215",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Wayne, NJ

Sources for this page

Verify at the official NPI Registry.