Individual provider Active NPI

Diana Domingo Hearn, D.O.

  • Urogynecology and Reconstructive Pelvic Surgery (Obstetrics & Gynecology) Physician
  • Teaneck, NJ
National Provider Identifier
1558748129
Registry record updated Jul 5, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urogynecology and Reconstructive Pelvic Surgery (Obstetrics & Gynecology) PhysicianTaxonomy code 207VF0040X
License
25MB10082700 Issued in NJ
Practice address
222 Cedar LN Ste 207
Teaneck, NJ 07666-4312
Phone
(201) 833-7087
Fax
(201) 833-7123
NPI assigned
May 2, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 5, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Urogynecology and Reconstructive Pelvic Surgery (Obstetrics & Gynecology) Physician 207VF0040X 25MB10082700 NJ Primary

Addresses

Primary practice location

222 Cedar LN Ste 207
Teaneck, NJ 07666-4312

Mailing address

222 Cedar LN Ste 207
Teaneck, NJ 07666-4312
Phone (201) 833-7087

Other identifiers 1

IdentifierTypeStateIssuer
0739324MedicaidNJ

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: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20200429001042 NY Practitioner - Obstetrics/Gynecology 7719224278 Reassigns benefits to 1 organization
I20200925000627 NJ Practitioner - Obstetrics/Gynecology 7719224278 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
New York College of Osteo Medicine of New York Institute of Technology, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Excelcare Medical Associates PAGroup PAC ID 4284647868, 200 clinicians

Practice addresses (Care Compare)

222 Cedar LN
Suite 207
Teaneck, NJ 07666-4312
Phone (201) 833-7087

Hospital & facility affiliations

  • Holy Name Medical Center Hospital, Teaneck, NJ, CCN 310008
  • Englewood Hospital and Medical Center Hospital, Englewood, NJ, CCN 310045
  • Hackensack University Medical Center Hospital, Hackensack, NJ, CCN 310001

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of the uterus1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

Practice roles

OrganizationSpecialtyStatusNew patients
Excelcare Medical Associates, PA CurrentSince Sep 9, 2020 Accepting new patients
North Shore-Lij Medical PC CurrentSince Mar 1, 2020 Accepting new patients

Locations

1 W Ridgewood Ave
Ste 203
Paramus, NJ 07652
Phone (201) 312-5243

222 Cedar Ln
Ste 103
Teaneck, NJ 07666
Phone (201) 692-0004

222 Cedar Ln
Ste 207
Teaneck, NJ 07666
Phone (201) 833-7087

718 Teaneck Rd
Teaneck, NJ 07666
Phone (201) 833-3232

10201 66th Rd
Forest Hills, NY 11375
Phone (718) 830-4091

300 Community Dr
Plandome, NY 11030

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 5

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": "1430524800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1656979200000",
    "number": "1558748129",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "222 CEDAR LN STE 207",
            "city": "TEANECK",
            "state": "NJ",
            "postal_code": "076664312",
            "telephone_number": "201-833-7087"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "222 CEDAR LN STE 207",
            "city": "TEANECK",
            "state": "NJ",
            "postal_code": "076664312",
            "telephone_number": "201-833-7087",
            "fax_number": "201-833-7123"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HEARN",
        "first_name": "DIANA",
        "middle_name": "DOMINGO",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-05-02",
        "last_updated": "2022-07-05",
        "certification_date": "2022-07-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207VF0040X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Urogynecology and Reconstructive Pelvic Surgery",
            "state": "NJ",
            "license": "25MB10082700",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0739324",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Teaneck, NJ

Sources for this page

Verify at the official NPI Registry.