Individual provider Active NPI

Diane Sirajudeen, DNP, MSN

  • Family Nurse Practitioner
  • Philadelphia, PA
National Provider Identifier
1497464911
Registry record updated Nov 23, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
F11220761 Issued in PA
Practice address
333 Cottman Ave
Philadelphia, PA 19111-2434
Phone
(215) 983-5187
NPI assigned
Nov 23, 2022
Last updated
Nov 23, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 23, 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 F11220761 PA Primary

Addresses

Primary practice location

333 Cottman Ave
Philadelphia, PA 19111-2434

Mailing address

3429 Debra Dr
Bensalem, PA 19020-1508
Phone (215) 983-5187

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
I20231218000988 PA Practitioner - Nurse Practitioner 8628427556 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
81.21 of 100Reported as group
Quality
49.71
Promoting interoperability
100
Improvement activities
40
Cost
74.23

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
F11220761PAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Temple Physician Inc. CurrentSince Nov 13, 2023 Accepting new patients
Temple Faculty Practice Plan Inc CurrentSince Nov 13, 2023 Accepting new patients
Temple Physicians Inc. CurrentSince Nov 13, 2023 Accepting new patients
Temple Faculty Practice Plan Inc Current Accepting new patients
Temple Faculty Practice Plan, Inc CurrentSince Nov 13, 2023 Accepting new patients
Temple Physicians Inc Current Accepting new patients
Temple Faculty Practice Plan Inc Past Accepting new patients

Locations

515 Pennsylvania Ave
Fl 2
Ft Washington, PA 19034
Phone (215) 540-0120

2301 E Allegheny Ave
Fl 1
Philadelphia, PA 19134
Phone (215) 291-3880

333 Cottman Ave
Philadelphia, PA 19111
Phone (215) 728-3893

3401 N Broad St
Philadelphia, PA 19140
Phone (215) 707-3807

3500 N Broad St
Philadelphia, PA 19140
Phone (215) 707-3656

Organizations & group practices 7

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": "1669161600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1669161600000",
    "number": "1497464911",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3429 DEBRA DR",
            "city": "BENSALEM",
            "state": "PA",
            "postal_code": "190201508",
            "telephone_number": "215-983-5187"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "333 COTTMAN AVE",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191112434",
            "telephone_number": "215-983-5187"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIRAJUDEEN",
        "first_name": "DIANE",
        "credential": "DNP, MSN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-11-23",
        "last_updated": "2022-11-23",
        "certification_date": "2022-11-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "PA",
            "license": "F11220761",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.