Individual provider Active NPI

Diane Erianne, PA

  • Medical Physician Assistant
  • Livingston, NJ
National Provider Identifier
1487687422
Registry record updated Jan 28, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
25MP00283000 Issued in NJ
Practice address
75 E Northfield Rd
Livingston, NJ 07039-4532
Phone
(973) 436-1500
NPI assigned
Jul 9, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 28, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 25MP00283000 NJ Primary

Addresses

Primary practice location

75 E Northfield Rd
Livingston, NJ 07039-4532

Mailing address

56 Franklin St
3Rd Floor
Waterbury, CT 06706-1221
Phone (203) 709-8873

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VT
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
I20220531002738 VT Practitioner - Physician Assistant 3971504879 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Northwestern Medical Center, Inc CurrentSince Jun 2, 2022 Accepting new patients
Northwestern Medical Center Inc CurrentSince Jun 2, 2022 Accepting new patients
Franklin Medical Group, PC Past Accepting new patients

Locations

3 Crest Rd
Saint Albans, VT 05478
Phone (802) 524-4554

133 Fairfield St
Saint Albans, VT 05478
Phone (802) 524-1227

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1152403200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1580169600000",
    "number": "1487687422",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "56 FRANKLIN ST",
            "address_2": "3RD FLOOR",
            "city": "WATERBURY",
            "state": "CT",
            "postal_code": "067061221",
            "telephone_number": "203-709-8873",
            "fax_number": "203-709-8689"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "75 E NORTHFIELD RD",
            "city": "LIVINGSTON",
            "state": "NJ",
            "postal_code": "070394532",
            "telephone_number": "973-436-1500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ERIANNE",
        "first_name": "DIANE",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-09",
        "last_updated": "2020-01-28",
        "certification_date": "2020-01-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NJ",
            "license": "25MP00283000",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Livingston, NJ

Sources for this page

Verify at the official NPI Registry.