Individual provider Active NPI

Diana Deinarowicz Gardiner, CRNP

  • Family Nurse Practitioner
  • Philadelphia, PA
National Provider Identifier
1205024148
Registry record updated Nov 29, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
SP008504 Issued in PA
Practice address
235 S 8TH St
Philadelphia, PA 19106-3519
Phone
(215) 829-6700
NPI assigned
Oct 4, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 29, 2012

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X SP008504 PA Primary
Family Nurse Practitioner 363LF0000X 26NJ00372200 NJ

Addresses

Primary practice location

235 S 8TH St
Philadelphia, PA 19106-3519

Mailing address

235 S 8TH St
Philadelphia, PA 19106-3519
Phone (215) 829-6700

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA, NJ2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20121218000443 PA Practitioner - Nurse Practitioner 6709038854 Reassigns benefits to 1 organization
I20121218000482 NJ Practitioner - Nurse Practitioner 6709038854 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
SP008504PAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
University of Penn-Medical Group CurrentSince Oct 14, 2018 Accepting new patients
University of Penn-Medical Group Current Accepting new patients
Clinical Health Care Associates of New Jersey, PC CurrentSince Nov 20, 2017 Accepting new patients
Clinical Health Care Associates of New Jersey, PC Current Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients

Locations

1865 Route 70 E
Ste 220
Cherry Hill, NJ 08003
Phone (856) 429-0505

3205 Fire Rd
Egg Hbr Twp, NJ 08234
Phone (609) 407-1113

1006 Mantua Pike
Woodbury Hts, NJ 08097
Phone (856) 845-6880

3400 Spruce St
Fl 3
Philadelphia, PA 19104

Organizations & group practices 6

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": "1191456000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1354147200000",
    "number": "1205024148",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "235 S 8TH ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191063519",
            "telephone_number": "215-829-6700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "235 S 8TH ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191063519",
            "telephone_number": "215-829-6700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GARDINER",
        "first_name": "DIANA",
        "middle_name": "DEINAROWICZ",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-10-04",
        "last_updated": "2012-11-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "PA",
            "license": "SP008504",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NJ",
            "license": "26NJ00372200",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.