Individual provider Active NPI

Diane McQuillen, D.O.

  • Internal Medicine Physician
  • Egg Harbor Township, NJ
National Provider Identifier
1609262179
Registry record updated Apr 1, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
25MB10720200 Issued in NJ
Practice address
3003 English Creek Ave Ste C6
Egg Harbor Township, NJ 08234-4818
Phone
(609) 481-3185
Fax
(609) 704-5615
NPI assigned
Apr 12, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 1, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X OS019488 PA
Internal Medicine Physician 207R00000X 25MB10720200 NJ Primary

Addresses

Primary practice location

3003 English Creek Ave Ste C6
Egg Harbor Township, NJ 08234-4818

Mailing address

PO Box 1309
Marlton, NJ 08053-6309
Phone (609) 567-0200

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200515000100 NJ Practitioner - Internal Medicine 1456690742 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
West Virginia School of Osteopathic Medicine, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Southern Jersey Family Medical Centers, IncGroup PAC ID 0547170763, 42 clinicians

Practice addresses (Care Compare)

3003 English Creek Ave
Suite C
Egg Harbor Township, NJ 08234-4892
Phone (609) 481-3185

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
OS019488PAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Southern Jersey Family Medical Centers, Inc CurrentSince Apr 16, 2024 Accepting new patients
Atlanticare Physician Group, PA CurrentSince Apr 23, 2023 Accepting new patients
The Osborn Family Health Center, Inc. Current Accepting new patients
The Osborn Family Health Center, Inc. CurrentSince May 15, 2023 Accepting new patients
Southern Jersey Family Medical Centers, Inc. CurrentSince Apr 16, 2024 Accepting new patients
Atlanticare Physician Group PA CurrentSince Apr 23, 2023 Accepting new patients
Southern Jersey Family Medical Centers, Inc. PastSince Apr 9, 2024 Accepting new patients
Inspira Health Network Medical Group, P.C. Past Accepting new patients
Atlanticare Regional Medical Center Past Accepting new patients

Locations

1601 Haddon Ave
Camden, NJ 08103
Phone (856) 757-3700

3003 English Creek Ave
Ste C6
Egg Harbor Twp, NJ 08234
Phone (609) 481-3185

860 S White Horse Pike
Hammonton, NJ 08037
Phone (609) 567-0200

459 Route 9 S
Little Egg Harbor Twp, NJ 08087
Phone (609) 340-7815

65 W Jimmie Leeds Rd
Pomona, NJ 08240
Phone (609) 484-6414

Interoperability endpoints

  • FHIR API: https://fhir-api.fhirprod.aws.greenwayhealth.com/fhir/R4/2.16.840.1.113883.3.140.72983

Organizations & group practices 9

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": "1428796800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1711929600000",
    "number": "1609262179",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1309",
            "city": "MARLTON",
            "state": "NJ",
            "postal_code": "080536309",
            "telephone_number": "609-567-0200",
            "fax_number": "609-704-5615"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3003 ENGLISH CREEK AVE STE C6",
            "city": "EGG HARBOR TOWNSHIP",
            "state": "NJ",
            "postal_code": "082344818",
            "telephone_number": "609-481-3185",
            "fax_number": "609-704-5615"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCQUILLEN",
        "first_name": "DIANE",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-04-12",
        "last_updated": "2024-04-01",
        "certification_date": "2024-04-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "PA",
            "license": "OS019488",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NJ",
            "license": "25MB10720200",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Egg Harbor Township, NJ

Sources for this page

Verify at the official NPI Registry.