Individual provider Active NPI

Dina Prus, MD

  • Endocrinology, Diabetes & Metabolism Physician
  • Maplewood, NJ
National Provider Identifier
1871565887
Registry record updated Feb 7, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Endocrinology, Diabetes & Metabolism PhysicianTaxonomy code 207RE0101X
License
MA69784 Issued in NJ
Practice address
264 Boyden Ave
Empire Medical Group
Maplewood, NJ 07040-3070
Phone
(973) 761-5200
Fax
(973) 761-7617
NPI assigned
Feb 3, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 7, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Endocrinology, Diabetes & Metabolism Physician 207RE0101X MA69784 NJ Primary

Addresses

Primary practice location

264 Boyden Ave
Empire Medical Group
Maplewood, NJ 07040-3070

Mailing address

264 Boyden Ave
Empire Medical Group
Maplewood, NJ 07040-3070
Phone (973) 761-5200

Other names 1

  • Dina Prus-Wertheimer Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ, FL2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20051027000836 NJ Practitioner - EndocrinologyPractitioner - Internal Medicine 1456378512 Reassigns benefits to 1 organization
I20260513003858 FL Practitioner - Endocrinology 1456378512 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Endocrinology
Education
Other, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

2633 Centennial Blvd
Suite 100
Tallahassee, FL 32308-0606
Phone (850) 431-5404

324 Palisade Ave
FL 2
Jersey City, NJ 07307-1791
Phone (201) 386-1400

Merit-based Incentive Payment System (MIPS)

Final score
85.15 of 100Reported as group
Quality
71.59
Promoting interoperability
100
Improvement activities
40
Cost
76.65

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MA69784NJMDEndocrinology, Diabetes & Metabolism Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Optum Medical Care of New Jersey PC CurrentSince Nov 1, 2019 Accepting new patients
Optum Medical Care of New Jersey PC CurrentSince Nov 1, 2019 Accepting new patients
Hospitalists Emo, LLC Past Accepting new patients
Summit Medical Group PA Past Accepting new patients
Hospital Authority of the City of Bainbridge and Decatur County Past Accepting new patients

Locations

935 River Rd
Ste 301
Edgewater, NJ 07020
Phone (201) 471-7012

324 Palisade Ave
Fl 2
Jersey City, NJ 07307
Phone (201) 386-1400

264 Boyden Ave
Maplewood, NJ 07040
Phone (973) 761-0764

3403 S Delsea Dr
Vineland, NJ 08360
Phone (856) 293-6974

Interoperability endpoints

  • Direct secure messaging: dprus77106@direct.optum.com

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1138924800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1328572800000",
    "number": "1871565887",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "264 BOYDEN AVE",
            "address_2": "EMPIRE MEDICAL GROUP",
            "city": "MAPLEWOOD",
            "state": "NJ",
            "postal_code": "070403070",
            "telephone_number": "973-761-5200",
            "fax_number": "973-761-7617"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "264 BOYDEN AVE",
            "address_2": "EMPIRE MEDICAL GROUP",
            "city": "MAPLEWOOD",
            "state": "NJ",
            "postal_code": "070403070",
            "telephone_number": "973-761-5200",
            "fax_number": "973-761-7617"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PRUS",
        "first_name": "DINA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-02-03",
        "last_updated": "2012-02-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RE0101X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "NJ",
            "license": "MA69784",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DINA",
            "last_name": "PRUS-WERTHEIMER",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Maplewood, NJ

Sources for this page

Verify at the official NPI Registry.