Individual provider Active NPI

Diego Urdaneta, MD

  • Anesthesiology Physician
  • Philadelphia, PA
National Provider Identifier
1821527060
Registry record updated May 28, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
25MA11091000 Issued in NJ
Practice address
230 N Broad St
Philadelphia, PA 19102-1121
Phone
(215) 762-7000
NPI assigned
Jun 10, 2017
Last updated
May 28, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 28, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 25MA11091000 NJ Primary
Internal Medicine Physician 207R00000X MT214037 PA

Addresses

Primary practice location

230 N Broad St
Philadelphia, PA 19102-1121

Mailing address

700 Mullica Hill Rd
Mullica Hill, NJ 08062-4413
Phone (856) 508-1000

Other practice location 1

136 Route 73 Ste C
Voorhees, NJ 08043-9598
Phone (856) 295-0240

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
I20211118002729 NJ Practitioner - Anesthesiology 6507194982 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
Drexel University College of Medicine, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Summit Medical Group PAGroup PAC ID 5395642276, 1,204 clinicians
Parkway Anesthesia Associates LLCGroup PAC ID 2567758931, 313 clinicians

Practice addresses (Care Compare)

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

300 Central Ave
East Orange, NJ 07018-2819
Phone (973) 672-8400

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
89.65 of 100Reported as group
Quality
85.05
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
25MA11091000NJMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Summit Medical Group PA CurrentSince Apr 30, 2025 Accepting new patients
Parkway Anesthesia Associates LLC Anesthesiology CurrentSince Apr 1, 2025 Accepting new patients
South Jersey Anesthesia and Pain Physicians PC Anesthesiology CurrentSince Aug 13, 2021 Accepting new patients
Summit Medical Group PA CurrentSince Apr 30, 2025 Accepting new patients
Summit Medical Group PA PastSince Jun 12, 2022 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

300 Central Ave
East Orange, NJ 07018
Phone (973) 266-8460

1 Bay Ave
Montclair, NJ 07042
Phone (973) 429-6100

700 Mullica Hill Rd
Mullica Hill, NJ 08062
Phone (856) 508-1000

99 State Route 37 W
Toms River, NJ 08755
Phone (732) 240-8000

509 N Broad St
Woodbury, NJ 08096
Phone (856) 686-5396

Organizations & group practices 6

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 3

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": "1497052800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1748390400000",
    "number": "1821527060",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "700 MULLICA HILL RD",
            "city": "MULLICA HILL",
            "state": "NJ",
            "postal_code": "080624413",
            "telephone_number": "856-508-1000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "230 N BROAD ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191021121",
            "telephone_number": "215-762-7000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "136 Route 73 Ste C",
            "address_purpose": "LOCATION",
            "city": "Voorhees",
            "state": "NJ",
            "postal_code": "080439598",
            "country_code": "US",
            "telephone_number": "856-295-0240",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "URDANETA",
        "first_name": "DIEGO",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-06-10",
        "last_updated": "2025-05-28",
        "certification_date": "2025-05-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "NJ",
            "license": "25MA11091000",
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "PA",
            "license": "MT214037",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.