Individual provider Active NPI

Kimberly Dachisen, NP

  • Pediatric Nurse Practitioner
  • Newton, NJ
National Provider Identifier
1457917007
Registry record updated Jul 5, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
26NJ01437200 Issued in NJ
Practice address
39 Newton Sparta Rd
Newton, NJ 07860-2773
Phone
(973) 383-9841
NPI assigned
May 18, 2019
Last updated
Jul 5, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 5, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 344395 NY
Family Nurse Practitioner 363LF0000X 26NJ01437200 NJ
Pediatric Nurse Practitioner 363LP0200X 26NJ01437200 NJ Primary

Addresses

Primary practice location

39 Newton Sparta Rd
Newton, NJ 07860-2773

Mailing address

401 Route 73 N Ste 320
Marlton, NJ 08053-3426
Phone (973) 383-9841

Other practice location 1

1275 York Ave
New York, NY 10065-6007
Phone (212) 639-2000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, 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
I20191119000526 NY Practitioner - Nurse Practitioner 1850723545 Reassigns benefits to 1 organization
I20230314000266 NJ Practitioner - Nurse Practitioner 1850723545 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
344395NYMDFamily Nurse Practitioner
26NJ01437200NJMDPediatric Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Memorial Pediatric Group CurrentSince Sep 25, 2019 Accepting new patients
Advocare, LLC CurrentSince Mar 6, 2023 Accepting new patients
Advocare , LLC CurrentSince Mar 6, 2023 Accepting new patients
Advocare, LLC Past Accepting new patients

Locations

169 Mine Brook Rd
#P
Bernardsville, NJ 07924
Phone (908) 766-0034

132 Grove St
Ste A
Haddonfield, NJ 08033
Phone (856) 354-2211

401 Route 73 N
Ste 320
Marlton, NJ 08053
Phone (609) 471-1033

25 Lindsley Dr
Ste 205
Morristown, NJ 07960
Phone (973) 993-8777

39 Newton Sparta Rd
Newton, NJ 07860
Phone (973) 383-0153

1275 York Ave
New York, NY 10065
Phone (212) 639-3813

633 3rd Ave
Lbby 3
New York, NY 10017
Phone (848) 225-6000

Networks

  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H3359

Interoperability endpoints

  • Direct secure messaging: kimberly.dachisen@advocaredoctors.eclinicaldirectplus.com

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1558137600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1751673600000",
    "number": "1457917007",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "401 ROUTE 73 N STE 320",
            "city": "MARLTON",
            "state": "NJ",
            "postal_code": "080533426",
            "telephone_number": "973-383-9841"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "39 NEWTON SPARTA RD",
            "city": "NEWTON",
            "state": "NJ",
            "postal_code": "078602773",
            "telephone_number": "973-383-9841"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1275 York Ave",
            "address_purpose": "LOCATION",
            "city": "New York",
            "state": "NY",
            "postal_code": "100656007",
            "country_code": "US",
            "telephone_number": "212-639-2000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DACHISEN",
        "first_name": "KIMBERLY",
        "name_prefix": "Mrs.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-05-18",
        "last_updated": "2025-07-05",
        "certification_date": "2025-07-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "344395",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NJ",
            "license": "26NJ01437200",
            "primary": false
        },
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "NJ",
            "license": "26NJ01437200",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Newton, NJ

Sources for this page

Verify at the official NPI Registry.