Individual provider Active NPI

Dylan Nieman, MD PHD

  • Surgery Physician
  • New Brunswick, NJ
National Provider Identifier
1891936704
Registry record updated Apr 8, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
25MA09903700 Issued in NJ
Practice address
125 Paterson St Ste 4100
New Brunswick, NJ 08901-1962
Phone
(732) 235-7920
NPI assigned
Mar 23, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 8, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Critical Care Physician 2086S0102X 25MA09903700 NJ
Surgery Physician 208600000X 25MA09903700 NJ Primary

Addresses

Primary practice location

125 Paterson St Ste 4100
New Brunswick, NJ 08901-1962

Mailing address

1 Robert Wood Johnson PL
New Brunswick, NJ 08901-1928
Phone (732) 235-7920

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
I20160924000010 NJ Practitioner - General Surgery 0244527885 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
University of Southern California Keck School of Medicine, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

125 Paterson St
New Brunswick, NJ 08901-1962
Phone (732) 235-7920

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Hernia repair - groin (open)1-10
Hernia repair (minimally invasive)1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
25MA09903700NJMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Rutgers Health-RWJ Neurosurgery Faculty CurrentSince Feb 1, 2021 Accepting new patients
Rutgers Health-RWJ Neurosurgery Faculty CurrentSince Feb 1, 2021 Accepting new patients
Rutgers Health-RWJ Neurosurgery Faculty Surgery CurrentSince Jul 23, 2016 Accepting new patients
Rutgers Health-RWJ Neurosurgery Faculty Past Accepting new patients

Locations

10 Plum St
Fl 5
New Brunswick, NJ 08901
Phone (732) 235-5530

1 Rwj Pl
New Brunswick, NJ 08901
Phone (732) 235-7887

125 Paterson St
Ste 4100
New Brunswick, NJ 08901
Phone (732) 235-7756

125 Paterson St
New Brunswick, NJ 08901
Phone (732) 235-6511

Interoperability endpoints

  • Direct secure messaging: dnieman17949@epicdirect.rwjbh.org

Organizations & group practices 4

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 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": "1237766400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712534400000",
    "number": "1891936704",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 ROBERT WOOD JOHNSON PL",
            "city": "NEW BRUNSWICK",
            "state": "NJ",
            "postal_code": "089011928",
            "telephone_number": "732-235-7920"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "125 PATERSON ST STE 4100",
            "city": "NEW BRUNSWICK",
            "state": "NJ",
            "postal_code": "089011962",
            "telephone_number": "732-235-7920"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NIEMAN",
        "first_name": "DYLAN",
        "name_prefix": "Dr.",
        "credential": "MD PHD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-03-23",
        "last_updated": "2024-04-08",
        "certification_date": "2024-04-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086S0102X",
            "taxonomy_group": "",
            "desc": "Surgery, Surgical Critical Care",
            "state": "NJ",
            "license": "25MA09903700",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "NJ",
            "license": "25MA09903700",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New Brunswick, NJ

Sources for this page

Verify at the official NPI Registry.