Dirksen J. Taguiam, MSN, APN-C

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

26NJ00885000 Issued in NJ

Practice address

210 Jack Martin Blvd Ste D-1
Brick, NJ 08724-7771

Phone

(732) 458-5854

Fax

(732) 458-8012

NPI assigned

Dec 16, 2018

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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

Specialty

Nurse Practitioner

Education

Other, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Northeast Kidney Care LLCGroup PAC ID 8921445032, 66 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Community Medical Center Hospital, Toms River, NJ, CCN 310041
• Monmouth Medical Center-Southern Campus Hospital, Lakewood, NJ, CCN 310084

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science - Nursing, Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: dtaguiam19730@direct.acumenmd.com

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.

• Bridgehealth Solutions LLC

  • Adult Health Nurse Practitioner
  • Bayville, NJ
  • NPI 1942151550

  NJ

  Medicare reassignment NPD Authorized official
• Northeast Kidney Care LLC

  • Internal Medicine Physician
  • Brick, NJ
  • NPI 1023889565

  NJ

  Medicare reassignment Care Compare group NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Community Medical Center Inc

  • General Acute Care Hospital
  • Toms River, NJ
  • NPI 1013010917

  Hospital

  Care Compare affiliation
• Monmouth Medical Center Inc

  • General Acute Care Hospital
  • Lakewood, NJ
  • NPI 1225133473

  Hospital

  Care Compare affiliation
• Monmouth Medical Center Inc

  • General Acute Care Hospital
  • Long Branch, NJ
  • NPI 1609983790

  Hospital

  Care Compare affiliation

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1544918400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1577059200000",
    "number": "1639640790",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "210 JACK MARTIN BLVD STE D-1",
            "city": "BRICK",
            "state": "NJ",
            "postal_code": "087247771",
            "telephone_number": "732-458-5854",
            "fax_number": "732-458-8012"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "210 JACK MARTIN BLVD STE D-1",
            "city": "BRICK",
            "state": "NJ",
            "postal_code": "087247771",
            "telephone_number": "732-458-5854",
            "fax_number": "732-458-8012"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAGUIAM",
        "first_name": "DIRKSEN",
        "middle_name": "J.",
        "credential": "MSN, APN-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-12-16",
        "last_updated": "2019-12-23",
        "certification_date": "2019-12-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NJ",
            "license": "26NJ00885000",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jonathan Paul Sytko
• Amanda Christine Szajko, LAC
• Stanley J. Szaniawski, D.P.M.
• Stephanie Szoke, LPC
• T.a.E.L.L.C.
• Rachel Taillacq, RN, CA, CMT, CPT
• Nicolette Rose Takach, LPC
• Marie S Tallard, CBIS, CRT
• Allyson M Tamowski, OTR/L
• Eric Tan, FNP

• All providers in Brick, NJ
• Nurse Practitioner in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 23, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.