Individual provider Active NPI

Charlene Dziamniski

  • Family Nurse Practitioner
  • Aliquippa, PA
National Provider Identifier
1356095848
Registry record updated Feb 4, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
SP025083 Issued in PA
Practice address
2719 Brodhead Rd
Aliquippa, PA 15001-2793
Phone
(724) 419-9200
NPI assigned
Feb 4, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 4, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X SP025083 PA Primary

Addresses

Primary practice location

2719 Brodhead Rd
Aliquippa, PA 15001-2793

Mailing address

303 13TH St
Monaca, PA 15061-1926

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL Allscripts Health Information Exchange (HIE) Heritage Valley Medical Group, Inc.

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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
I20220317000418 PA Practitioner - Nurse Practitioner 6800281478 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Heritage Valley Multispecialty Group IncGroup PAC ID 0042105678, 229 clinicians

Practice addresses (Care Compare)

2719 Brodhead Rd
Aliquippa, PA 15001-2793
Phone (724) 419-9200

Hospital & facility affiliations

  • Heritage Valley Beaver Hospital, Beaver, PA, CCN 390036

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
SP025083PAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Heritage Valley Multispecialty Group, Inc. CurrentSince Feb 1, 2022 Accepting new patients
Heritage Valley Multispecialty Group, Inc. CurrentSince Feb 1, 2022 Accepting new patients

Locations

2719 Brodhead Rd
Aliquippa, PA 15001
Phone (724) 378-4411

2719 Brodhead Rd
Ste 190
Aliquippa, PA 15001
Phone (724) 419-9200

500 Sharon Rd
Beaver, PA 15009
Phone (724) 728-7683

2 Peartree Way
Beaver, PA 15009
Phone (724) 773-6802

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": "1643932800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1643932800000",
    "number": "1356095848",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "303 13TH ST",
            "city": "MONACA",
            "state": "PA",
            "postal_code": "150611926"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2719 BRODHEAD RD",
            "city": "ALIQUIPPA",
            "state": "PA",
            "postal_code": "150012793",
            "telephone_number": "724-419-9200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DZIAMNISKI",
        "first_name": "CHARLENE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-02-04",
        "last_updated": "2022-02-04",
        "certification_date": "2022-02-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "PA",
            "license": "SP025083",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Allscripts",
            "affiliation": "Y",
            "endpointDescription": "Medical records",
            "affiliationName": "Heritage Valley Medical Group, Inc.",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "2719 Brodhead Rd",
            "city": "Aliquippa",
            "state": "PA",
            "country_code": "US",
            "postal_code": "150012793",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Aliquippa, PA

Sources for this page

Verify at the official NPI Registry.