Individual provider Active NPI

Diem K Tran, APN

  • Family Medicine Physician
  • Cedar Knolls, NJ
National Provider Identifier
1679346514
Registry record updated Nov 2, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
26NJ14923800 Issued in NJ
Practice address
14 Ridgedale Ave Ste 103
Cedar Knolls, NJ 07927-1106
Phone
(973) 295-6335
Fax
(862) 204-3456
NPI assigned
Nov 2, 2023
Last updated
Nov 2, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 2, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 26NJ14923800 NJ Primary

Addresses

Primary practice location

14 Ridgedale Ave Ste 103
Cedar Knolls, NJ 07927-1106

Mailing address

46 Weathervane Cir
Cream Ridge, NJ 08514-2537
Phone (848) 234-7810

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
I20231121001388 NJ Practitioner - Nurse Practitioner 0042668691 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
NJ Memory and Behavioral CareGroup PAC ID 7719013267, 71 clinicians

Practice addresses (Care Compare)

14 Ridgedale Ave
Suite 103
Cedar Knolls, NJ 07927-1106
Phone (973) 295-6335

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as group

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
26NJ14923800NJMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
NJ Memory and Behavioral Care CurrentSince Nov 7, 2023 Accepting new patients

Locations

14 Ridgedale Ave
Ste 103
Cedar Knolls, NJ 07927
Phone (973) 295-6335

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1698883200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698883200000",
    "number": "1679346514",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "46 WEATHERVANE CIR",
            "city": "CREAM RIDGE",
            "state": "NJ",
            "postal_code": "085142537",
            "telephone_number": "848-234-7810"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14 RIDGEDALE AVE STE 103",
            "city": "CEDAR KNOLLS",
            "state": "NJ",
            "postal_code": "079271106",
            "telephone_number": "973-295-6335",
            "fax_number": "862-204-3456"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TRAN",
        "first_name": "DIEM",
        "middle_name": "K",
        "credential": "APN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-11-02",
        "last_updated": "2023-11-02",
        "certification_date": "2023-11-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NJ",
            "license": "26NJ14923800",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cedar Knolls, NJ

Sources for this page

Verify at the official NPI Registry.