Individual provider Active NPI

Waleska Lynn Diaz, DNP, FNP-C

  • Family Nurse Practitioner
  • Chatham, NJ
National Provider Identifier
1629653217
Registry record updated Jun 16, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
26NJ01128200 Issued in NJ
Practice address
471 Main St
Chatham, NJ 07928-2102
Phone
(973) 635-4636
NPI assigned
Mar 15, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 16, 2021

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 26NJ01128200 NJ Primary

Addresses

Primary practice location

471 Main St
Chatham, NJ 07928-2102

Mailing address

471 Main St
Chatham, NJ 07928-2102
Phone (973) 635-4635

Other practice location 1

345 Chandler Ave
Roselle, NJ 07203-1313
Phone (908) 906-4840

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
I20210728000013 NJ Practitioner - Nurse Practitioner 3870996994 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Excel Urgent Care of NJ LLCGroup PAC ID 9638396849, 21 clinicians

Practice addresses (Care Compare)

2624 Hwy 516
Old Bridge, NJ 08857-2306
Phone (732) 952-5000

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Garden State Healthcare Associates, LLC CurrentSince Dec 10, 2021 Accepting new patients
Hackensack Meridian Urgent Care, PC CurrentSince Nov 1, 2023 Accepting new patients
Excel Urgent Care of NJ LLC CurrentSince May 25, 2023 Accepting new patients
Jersey Irish Medical CurrentSince Apr 22, 2022 Accepting new patients
Northern Ohio Medical Specialists, LLC PastSince Nov 1, 2023 Accepting new patients

Locations

601 W Union Ave
Bound Brook, NJ 08805
Phone (732) 469-3627

601 W Union Ave
Ste 1
Bound Brook, NJ 08805
Phone (732) 469-3627

1180 Raritan Rd
Clark, NJ 07066
Phone (848) 308-4515

400 Westfield Ave
Elizabeth, NJ 07208
Phone (908) 428-8001

308 Willow Ave
Hoboken, NJ 07030
Phone (201) 418-1574

740 Route 1 N
Ste 2
Iselin, NJ 08830
Phone (732) 874-5507

740 US Highway 1 N
Iselin, NJ 08830
Phone (732) 362-3840

176 Palisade Ave
Jersey City, NJ 07306
Phone (201) 795-8200

215 Applegarth Rd
Monroe Twp, NJ 08831
Phone (848) 888-4436

2624 Highway 516
Old Bridge, NJ 08857
Phone (973) 671-8775

214 State Route 36
West Long Branch, NJ 07764
Phone (732) 222-8000

484 Temple Hill Rd
Ste 103
New Windsor, NY 12553

Interoperability endpoints

  • Direct secure messaging: hackensackmeridian.waleskadiaz@136290.advancedmd-direct.com

Organizations & group practices 6

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": "1615766400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623801600000",
    "number": "1629653217",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "471 MAIN ST",
            "city": "CHATHAM",
            "state": "NJ",
            "postal_code": "079282102",
            "telephone_number": "973-635-4635"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "471 MAIN ST",
            "city": "CHATHAM",
            "state": "NJ",
            "postal_code": "079282102",
            "telephone_number": "973-635-4636"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "345 Chandler Ave",
            "address_purpose": "LOCATION",
            "city": "Roselle",
            "state": "NJ",
            "postal_code": "072031313",
            "country_code": "US",
            "telephone_number": "908-906-4840",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DIAZ",
        "first_name": "WALESKA",
        "middle_name": "LYNN",
        "name_prefix": "Dr.",
        "credential": "DNP, FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-03-15",
        "last_updated": "2021-06-16",
        "certification_date": "2021-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NJ",
            "license": "26NJ01128200",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chatham, NJ

Sources for this page

Verify at the official NPI Registry.