Individual provider Active NPI

Aissata Diawara, M.D

  • Neurology Physician
  • Sewell, NJ
National Provider Identifier
1245764232
Registry record updated Nov 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
25MA11989900 Issued in NJ
Practice address
239 Hurffville Crosskeys Rd Ste 480a
Sewell, NJ 08080-4002
Phone
(856) 988-3444
NPI assigned
Apr 17, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 19, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 25MA11989900 NJ
Neurology Physician 2084N0400X 25MA11989900 NJ Primary

Addresses

Primary practice location

239 Hurffville Crosskeys Rd Ste 480a
Sewell, NJ 08080-4002

Mailing address

301 Lippincott Dr Ste 410
Marlton, NJ 08053-4197
Phone (856) 355-0340

Other practice location 1

1001 Route 73 N Uppr Level A & Main Level
Marlton, NJ 08053-4524
Phone (856) 988-3444

Other identifiers 1

IdentifierTypeStateIssuer
0983373MedicaidNJ

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address adiawara257973@directvirtua.org
Direct Messaging Address adiawara257973@directvirtua.org

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
I20231111000455 NJ Practitioner - Neurology 7618249269 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Neurology
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Virtua Medical Group, PAGroup PAC ID 9830222397, 1,678 clinicians

Practice addresses (Care Compare)

239 Hurffville Crosskeys Rd
Sewell, NJ 08080-4002
Phone (856) 988-3444

Hospital & facility affiliations

  • West Jersey Hospital Hospital, Voorhees, NJ, CCN 310022
  • Virtua Our Lady of Lourdes Hospital Hospital, Camden, NJ, CCN 310029
  • Virtua Mount Holly Hospital Hospital, Mount Holly, NJ, CCN 310057

Merit-based Incentive Payment System (MIPS)

Final score
81.15 of 100Reported as group
Quality
62.28
Promoting interoperability
100
Improvement activities
40
Cost
74.89

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
25MA11989900NJMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Virtua Medical Group, PA CurrentSince Oct 29, 2023 Accepting new patients
Virtua Medical Group, PA CurrentSince Oct 29, 2023 Accepting new patients

Locations

3242 Route 206
Ste 2
Bordentown, NJ 08505
Phone (609) 298-4340

1001 Route 73 N
Uppr
Marlton, NJ 08053
Phone (856) 355-7137

301 Lippincott Dr
Ste 410
Marlton, NJ 08053

303 Lippincott Dr
Ste 200
Marlton, NJ 08053
Phone (856) 355-0335

239 Hurffville Crosskeys Rd
Ste 480A
Sewell, NJ 08080

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.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1492387200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731974400000",
    "number": "1245764232",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "301 LIPPINCOTT DR STE 410",
            "city": "MARLTON",
            "state": "NJ",
            "postal_code": "080534197",
            "telephone_number": "856-355-0340"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "239 HURFFVILLE CROSSKEYS RD STE 480A",
            "city": "SEWELL",
            "state": "NJ",
            "postal_code": "080804002",
            "telephone_number": "856-988-3444"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1001 Route 73 N Uppr Level A & Main Level",
            "address_purpose": "LOCATION",
            "city": "Marlton",
            "state": "NJ",
            "postal_code": "080534524",
            "country_code": "US",
            "telephone_number": "856-988-3444",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DIAWARA",
        "first_name": "AISSATA",
        "name_prefix": "Dr.",
        "credential": "M.D",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-04-17",
        "last_updated": "2024-11-19",
        "certification_date": "2024-11-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NJ",
            "license": "25MA11989900",
            "primary": false
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "NJ",
            "license": "25MA11989900",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0983373",
            "state": "NJ"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "adiawara257973@directvirtua.org",
            "affiliation": "N",
            "address_1": "1001 Route 73 N Uppr Level A & Main Level",
            "city": "Marlton",
            "state": "NJ",
            "country_code": "US",
            "postal_code": "080534524",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "adiawara257973@directvirtua.org",
            "affiliation": "N",
            "address_1": "239 Hurffville Crosskeys Rd Ste 480A",
            "city": "Sewell",
            "state": "NJ",
            "country_code": "US",
            "postal_code": "080804002",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Sewell, NJ

Sources for this page

Verify at the official NPI Registry.