Individual provider Active NPI

Izee Mer Dizon, MSN, RN, APN

  • Adult Health Nurse Practitioner
  • Bridgewater, NJ
National Provider Identifier
1336754977
Registry record updated Sep 10, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
26NJ01051800 Issued in NJ
Practice address
77 Maple St
Bridgewater, NJ 08807-2752
Phone
(908) 300-4598
NPI assigned
Sep 10, 2020
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 10, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Gerontology Nurse Practitioner 363LG0600X 26NJ01051800 NJ
Adult Health Nurse Practitioner 363LA2200X 26NJ01051800 NJ Primary

Addresses

Primary practice location

77 Maple St
Bridgewater, NJ 08807-2752

Mailing address

77 Maple St
Bridgewater, NJ 08807-2752
Phone (908) 300-4598

Electronic endpoints 1

TypeEndpointUseAffiliation
SOAP URL NA

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
I20231104000153 NJ Practitioner - Nurse Practitioner 5294182879 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science - Nursing, Nurse Practitioner, Registered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Signify Health Medical Associates of New Jersey, LLC CurrentSince Jul 20, 2023 Accepting new patients

Locations

116 Village Blvd
Ste 200
Princeton, NJ 08540
Phone (609) 285-3094

4055 Valley View Ln
Ste 400
Dallas, TX 75244
Phone (469) 466-7037

Interoperability endpoints

  • Direct secure messaging: idizon58973@epicdirect.rwjbh.org

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": "1599696000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1599696000000",
    "number": "1336754977",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "77 MAPLE ST",
            "city": "BRIDGEWATER",
            "state": "NJ",
            "postal_code": "088072752",
            "telephone_number": "908-300-4598"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "77 MAPLE ST",
            "city": "BRIDGEWATER",
            "state": "NJ",
            "postal_code": "088072752",
            "telephone_number": "908-300-4598"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIZON",
        "first_name": "IZEE MER",
        "name_prefix": "Mr.",
        "credential": "MSN, RN, APN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-09-10",
        "last_updated": "2020-09-10",
        "certification_date": "2020-07-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "NJ",
            "license": "26NJ01051800",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NJ",
            "license": "26NJ01051800",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "NA",
            "affiliation": "N",
            "address_1": "77 Maple St",
            "city": "Bridgewater",
            "state": "NJ",
            "country_code": "US",
            "postal_code": "088072752",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Bridgewater, NJ

Sources for this page

Verify at the official NPI Registry.