Individual provider Active NPI

Diedre Willer, CNM

  • Advanced Practice Midwife
  • Brooklyn, NY
National Provider Identifier
1811560725
Registry record updated Jul 19, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Advanced Practice MidwifeTaxonomy code 367A00000X
License
002088 Issued in NY
Practice address
1 Brookdale PLZ
Brooklyn, NY 11212-3139
Phone
(929) 422-1836
NPI assigned
Jul 19, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 19, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Advanced Practice Midwife 367A00000X 002088 NY Primary

Addresses

Primary practice location

1 Brookdale PLZ
Brooklyn, NY 11212-3139

Mailing address

728 Bristol St Apt 2R
Brooklyn, NY 11236-1372
Phone (929) 519-8356

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20211109000558 NY Practitioner - Certified Nurse Midwife (CNM) 5496144768 Reassigns benefits to 7 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Nurse Midwife (CNM)
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Interfaith Professional Physician Services PCGroup PAC ID 9931378171, 383 clinicians

Practice addresses (Care Compare)

1 Brookdale PLZ
Brooklyn, NY 11212-3198

1545 Atlantic Ave
Brooklyn, NY 11213-1122
Phone (718) 613-4000

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Midwife

State licenses

LicenseStateTypeSpecialty
002088NYMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
The Brookdale Hospital Medical Center CurrentSince Sep 10, 2021 Accepting new patients
Brookdale Hospital Medical Center CurrentSince Sep 10, 2021 Accepting new patients
Maimonides Faculty Practice Plan CurrentSince Dec 23, 2022 Accepting new patients
MMC OB-GYN Faculty Practice Plan CurrentSince Dec 23, 2022 Accepting new patients
Interfaith Professional Physician Services, P.C. CurrentSince Jul 25, 2024 Accepting new patients
Brookdale Family Care Center, Inc. Current Accepting new patients
Brookdale Family Care Center, Inc. CurrentSince Mar 1, 2022 Accepting new patients
Urban Strategies Brookdale Family Care Center Inc CurrentSince Mar 1, 2022 Accepting new patients
Maimonides Medical Center MMC Midwifery CurrentSince Dec 23, 2022 Accepting new patients
MMC OB/GYN Hospital Past Accepting new patients

Locations

6208 4th Ave
Brooklyn, NY 11220
Phone (718) 283-3000

1 Brookdale Plz
Brooklyn, NY 11212
Phone (718) 240-5212

2525 Kings Hwy
Brooklyn, NY 11229
Phone (718) 692-5300

1873 Eastern Pkwy
Brooklyn, NY 11233
Phone (718) 240-5133

465 New Lots Ave
Brooklyn, NY 11207
Phone (718) 240-5133

4802 10th Ave
Brooklyn, NY 11219
Phone (718) 283-8724

1545 Atlantic Ave
Brooklyn, NY 11213
Phone (718) 613-4175

1235 Linden Blvd
Fl 2
Brooklyn, NY 11212
Phone (718) 240-7143

2554 Linden Blvd
Brooklyn, NY 11208
Phone (718) 240-5132

1616A Voorhies Ave
Brooklyn, NY 11235
Phone (718) 283-8225

Networks

  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H5989

Organizations & group practices 10

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.

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": "1626652800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1626652800000",
    "number": "1811560725",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "728 BRISTOL ST APT 2R",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112361372",
            "telephone_number": "929-519-8356"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 BROOKDALE PLZ",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112123139",
            "telephone_number": "929-422-1836"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLER",
        "first_name": "DIEDRE",
        "credential": "CNM",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-07-19",
        "last_updated": "2021-07-19",
        "certification_date": "2021-07-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367A00000X",
            "taxonomy_group": "",
            "desc": "Advanced Practice Midwife",
            "state": "NY",
            "license": "002088",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.