Individual provider Active NPI

Justina M Deitz, D.O.

  • Endocrinology, Diabetes & Metabolism Physician
  • Fair Lawn, NJ
National Provider Identifier
1699922880
Registry record updated Mar 21, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Endocrinology, Diabetes & Metabolism PhysicianTaxonomy code 207RE0101X
License
25MB08466800 Issued in NJ
Practice address
19-21 Fair Lawn Ave
Fair Lawn, NJ 07410-2331
Phone
(201) 620-3390
Fax
(201) 693-9965
NPI assigned
Aug 19, 2008
Last updated
Mar 21, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 21, 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 25MB08466800 NJ
Endocrinology, Diabetes & Metabolism Physician 207RE0101X 25MB08466800 NJ Primary

Addresses

Primary practice location

19-21 Fair Lawn Ave
Fair Lawn, NJ 07410-2331

Mailing address

180 Engle St
Englewood, NJ 07631-2507
Phone (201) 567-2050

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
I20080929000285 NJ Practitioner - EndocrinologyPractitioner - Internal Medicine 8123195484 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
EndocrinologyAlso: Internal Medicine
Education
New York College of Osteo Medicine of New York Institute of Technology, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Summit Medical Group PAGroup PAC ID 5395642276, 1,204 clinicians

Practice addresses (Care Compare)

1 Diamond Hill Rd
Berkeley Heights, NJ 07922-2104
Phone (908) 273-4300

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
25MB08466800NJMDEndocrinology, Diabetes & Metabolism Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Summit Medical Group PA CurrentSince Mar 19, 2018 Accepting new patients
Summit Medical Group PA CurrentSince Mar 19, 2018 Accepting new patients
Summit Medical Group, Inc Internal Medicine Past Accepting new patients

Locations

1 Diamond Hill Rd
Berkeley Heights, NJ 07922
Phone (908) 277-8868

180 Engle St
Englewood, NJ 07631
Phone (201) 567-2050

150 Floral Ave
New Providence, NJ 07974
Phone (908) 588-3890

Interoperability endpoints

  • Direct secure messaging: justina.deitz.1@2983.direct.athenahealth.com

Organizations & group practices 3

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.

Hospital & facility affiliations 4

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": "1219104000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710979200000",
    "number": "1699922880",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "180 ENGLE ST",
            "city": "ENGLEWOOD",
            "state": "NJ",
            "postal_code": "076312507",
            "telephone_number": "201-567-2050",
            "fax_number": "201-567-5070"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19-21 FAIR LAWN AVE",
            "city": "FAIR LAWN",
            "state": "NJ",
            "postal_code": "074102331",
            "telephone_number": "201-620-3390",
            "fax_number": "201-693-9965"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEITZ",
        "first_name": "JUSTINA",
        "middle_name": "M",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-08-19",
        "last_updated": "2024-03-21",
        "certification_date": "2024-03-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NJ",
            "license": "25MB08466800",
            "primary": false
        },
        {
            "code": "207RE0101X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "NJ",
            "license": "25MB08466800",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fair Lawn, NJ

Sources for this page

Verify at the official NPI Registry.