Individual provider Active NPI

Diane Marie Niestepski, P.A.

  • Physician Assistant
  • Hackettstown, NJ
National Provider Identifier
1508960543
Registry record updated Mar 19, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
25MP00157300 Issued in NJ
Practice address
653 Willow Grove St
Suite 2000
Hackettstown, NJ 07840-1732
Phone
(908) 684-3005
Fax
(908) 684-3301
NPI assigned
Sep 11, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 19, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 25MP00157300 NJ Primary
Surgical Physician Assistant 363AS0400X 25MP00157300 NJ

Addresses

Primary practice location

653 Willow Grove St
Suite 2000
Hackettstown, NJ 07840-1732

Mailing address

376 Lafayette Rd
Ste 202
Sparta, NJ 07871-3560
Phone (908) 684-3005

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
I20070119000317 NJ Practitioner - Physician Assistant 2062413974 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
North Jersey Sports Medicine and Orthopedic Center, LLCGroup PAC ID 6709895733, 29 clinicians

Practice addresses (Care Compare)

108 Bilby Rd
Suite 201
Hackettstown, NJ 07840-4174
Phone (908) 684-3005

376 Lafayette Rd
Suite 202
Sparta, NJ 07871-3560
Phone (908) 684-3005

711 Route 10 E
Suite 100
Randolph, NJ 07869-2030
Phone (908) 684-3005

Hospital & facility affiliations

  • Kessler Rehab Center Inpatient rehabilitation facility, West Orange, NJ, CCN 313025

Merit-based Incentive Payment System (MIPS)

Final score
89 of 100Reported as group
Quality
89.4
Promoting interoperability
97
Improvement activities
40
Cost
76.44

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
North Jersey Sports Medicine & Orthopedic Center, LLC CurrentSince May 4, 2009 Accepting new patients

Locations

108 Bilby Rd
Ste 201
Hackettstown, NJ 07840
Phone (908) 684-5646

653 Willow Grove St
Ste 2000
Hackettstown, NJ 07840
Phone (908) 522-5120

711 Route 10 E
Ste 100
Randolph, NJ 07869

376 Lafayette Rd
Ste 202
Sparta, NJ 07871
Phone (908) 684-2480

Interoperability endpoints

  • Direct secure messaging: dniestepski@orthopedicnj.medentdirect.com

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 1

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": "1157932800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1552953600000",
    "number": "1508960543",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "376 LAFAYETTE RD",
            "address_2": "STE 202",
            "city": "SPARTA",
            "state": "NJ",
            "postal_code": "078713560",
            "telephone_number": "908-684-3005",
            "fax_number": "908-684-3301"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "653 WILLOW GROVE ST",
            "address_2": "SUITE 2000",
            "city": "HACKETTSTOWN",
            "state": "NJ",
            "postal_code": "078401732",
            "telephone_number": "908-684-3005",
            "fax_number": "908-684-3301"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NIESTEPSKI",
        "first_name": "DIANE",
        "middle_name": "MARIE",
        "credential": "P.A.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-11",
        "last_updated": "2019-03-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NJ",
            "license": "25MP00157300",
            "primary": true
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "NJ",
            "license": "25MP00157300",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hackettstown, NJ

Sources for this page

Verify at the official NPI Registry.