Individual provider Active NPI

Diana Lorraine Saddel, D.O.

  • Family Medicine Physician
  • Sewell, NJ
National Provider Identifier
1831270610
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MB52186 Issued in NJ
Practice address
543 Egg Harbor Rd
Sewell, NJ 08080-2335
Phone
(856) 256-2063
Fax
(856) 256-2064
NPI assigned
Oct 18, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X MB52186 NJ Primary

Addresses

Primary practice location

543 Egg Harbor Rd
Sewell, NJ 08080-2335

Mailing address

3 Jasper Johns Way
Marlton, NJ 08053-7218
Phone (856) 809-0954

Other identifiers 1

IdentifierTypeStateIssuer
0723801MedicaidNJ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MB52186NJMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Charles L Dietzek, DO, Facos, PC PastSince Dec 26, 2017 Accepting new patients
Charles L. Dietzek Past Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1161129600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1831270610",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3 JASPER JOHNS WAY",
            "city": "MARLTON",
            "state": "NJ",
            "postal_code": "080537218",
            "telephone_number": "856-809-0954"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "543 EGG HARBOR RD",
            "city": "SEWELL",
            "state": "NJ",
            "postal_code": "080802335",
            "telephone_number": "856-256-2063",
            "fax_number": "856-256-2064"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SADDEL",
        "first_name": "DIANA",
        "middle_name": "LORRAINE",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-18",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NJ",
            "license": "MB52186",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0723801",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sewell, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.