Individual provider Active NPI

Amy Diep, PA-C

  • Medical Physician Assistant
  • Turnersville, NJ
National Provider Identifier
1790483147
Registry record updated Feb 6, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
Practice address
435 Hurffville Cross Keys Rd
Turnersville, NJ 08012-2453
Phone
(856) 649-6495
NPI assigned
Feb 15, 2023
Last updated
Feb 6, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 6, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X NU
Medical Physician Assistant 363AM0700X NU Primary

Addresses

Primary practice location

435 Hurffville Cross Keys Rd
Turnersville, NJ 08012-2453

Mailing address

407 Glendale Cir
Springfield, PA 19064-3818
Phone (610) 554-9877

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
I20230804002015 NJ Practitioner - Physician Assistant 4082075122 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Drexel University College of Medicine, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

435 Hurffville Cross Keys Rd
Turnersville, NJ 08012-2453
Phone (856) 513-4124

457 Haddonfield Rd
Suite 110
Cherry Hill, NJ 08002-2223
Phone (844) 542-2273

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Kennedy Medical Group Practice P.C. CurrentSince Aug 1, 2023 Accepting new patients
Kennedy Medical Group Practice PC CurrentSince Aug 1, 2023 Accepting new patients
Kennedy Medical Group Practice, P.C. PastSince Jun 15, 2021 Accepting new patients

Locations

457 Haddonfield Rd
Ste 110
Cherry Hill, NJ 08002
Phone (856) 406-4091

151 Fries Mill Rd
Ste 301
Turnersville, NJ 08012
Phone (856) 374-1881

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 1

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": "1676419200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707177600000",
    "number": "1790483147",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "407 GLENDALE CIR",
            "city": "SPRINGFIELD",
            "state": "PA",
            "postal_code": "190643818",
            "telephone_number": "610-554-9877"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "435 HURFFVILLE CROSS KEYS RD",
            "city": "TURNERSVILLE",
            "state": "NJ",
            "postal_code": "080122453",
            "telephone_number": "856-649-6495"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIEP",
        "first_name": "AMY",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-02-15",
        "last_updated": "2024-02-06",
        "certification_date": "2023-07-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Turnersville, NJ

Sources for this page

Verify at the official NPI Registry.