Organization Active NPI

Diane Brzezinski DO PA

  • Internal Medicine Physician
  • Naples, FL
National Provider Identifier
1730378175
Registry record updated Jul 6, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
OS7847 Issued in FL
Legal business name
DIANE BRZEZINSKI DO PA
Practice address
1250 Pine Ridge Rd Ste 101a
Naples, FL 34108-8913
Phone
(239) 261-9990
Fax
(239) 261-9993
NPI assigned
Oct 22, 2007
Last updated
Jul 6, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 6, 2021

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

Authorized official

Name
Dr. Diane J Brzezinski, DONPI 1447301544
Title
Owner
Phone
(239) 261-9990

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X OS7847 FL Primary

Addresses

Primary practice location

1250 Pine Ridge Rd Ste 101a
Naples, FL 34108-8913

Mailing address

1250 Pine Ridge Rd Ste 101a
Naples, FL 34108-8913
Phone (239) 261-9990

Other practice location 1

311 9th St N Ste 310
Naples, FL 34102-5889
Phone (239) 261-9990

Other identifiers 2

IdentifierTypeStateIssuer
1447301544OtherFLIND NPI
1447301544OtherFLNPI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20041106000001 FL Part B Supplier - Clinic/Group Practice 0648233023 Receives reassigned benefits from 5 practitioners
Practice locations: Naples, FL

National Provider Directory

National Provider Directory

Locations

1250 Pine Ridge Rd
Ste 101A
Naples, FL 34108
Phone (239) 261-9990

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/7883/brand/1/csg/1/fhir/r4

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1193011200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1625529600000",
    "number": "1730378175",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1250 PINE RIDGE RD STE 101A",
            "city": "NAPLES",
            "state": "FL",
            "postal_code": "341088913",
            "telephone_number": "239-261-9990",
            "fax_number": "239-261-9993"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1250 PINE RIDGE RD STE 101A",
            "city": "NAPLES",
            "state": "FL",
            "postal_code": "341088913",
            "telephone_number": "239-261-9990",
            "fax_number": "239-261-9993"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "311 9th St N Ste 310",
            "address_purpose": "LOCATION",
            "city": "Naples",
            "state": "FL",
            "postal_code": "341025889",
            "country_code": "US",
            "telephone_number": "239-261-9990",
            "fax_number": "239-261-9993",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "DIANE BRZEZINSKI DO PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-22",
        "last_updated": "2021-07-06",
        "certification_date": "2021-07-06",
        "status": "A",
        "authorized_official_last_name": "BRZEZINSKI",
        "authorized_official_first_name": "DIANE",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "239-261-9990",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "OS7847",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "IND NPI",
            "identifier": "1447301544",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1447301544",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Naples, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 6, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.