Individual provider Active NPI

Brianna C Dehl, PA-C

  • Surgical Physician Assistant
  • Brick, NJ
National Provider Identifier
1902398753
Registry record updated Dec 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
25MP00486600 Issued in NJ
Practice address
457 Jack Martin Blvd
Brick, NJ 08724-7776
Phone
(732) 840-7500
Fax
(732) 840-2088
NPI assigned
Jun 6, 2018
Last updated
Dec 9, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 9, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 25MP00486600 NJ
Surgical Physician Assistant 363AS0400X 25MP00486600 NJ Primary

Addresses

Primary practice location

457 Jack Martin Blvd
Brick, NJ 08724-7776

Mailing address

457 Jack Martin Blvd
Brick, NJ 08724-7776
Phone (732) 840-7500

Other names 1

  • Brianna Dziedzic Former name

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20181011000582 NJ Practitioner - Physician Assistant 3375895873 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Orthonj LLCGroup PAC ID 6800225178, 302 clinicians

Practice addresses (Care Compare)

2315 Route 34
Manasquan, NJ 08736-1444
Phone (732) 974-0404

457 Jack Martin Blvd
Suite 1
Brick, NJ 08724-7776
Phone (732) 840-7500

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
25MP00486600NJMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Orthonj LLC CurrentSince Apr 1, 2021 Accepting new patients
Orthonj LLC CurrentSince Apr 1, 2021 Accepting new patients
Rothman Institute of New Jersey, P.a. CurrentSince Dec 10, 2018 Accepting new patients

Locations

457 Jack Martin Blvd
Brick, NJ 08724
Phone (732) 840-7500

765 Lacey Rd
Forked River, NJ 08731
Phone (732) 840-7500

2315 Route 34
Manasquan, NJ 08736
Phone (732) 974-0404

999 Route 73 N
Ste 401
Marlton, NJ 08053
Phone (609) 617-3546

5 Plainsboro Rd
Ste 100
Plainsboro, NJ 08536
Phone (609) 750-1600

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 2

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": "1528243200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733702400000",
    "number": "1902398753",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "457 JACK MARTIN BLVD",
            "city": "BRICK",
            "state": "NJ",
            "postal_code": "087247776",
            "telephone_number": "732-840-7500",
            "fax_number": "732-840-2088"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "457 JACK MARTIN BLVD",
            "city": "BRICK",
            "state": "NJ",
            "postal_code": "087247776",
            "telephone_number": "732-840-7500",
            "fax_number": "732-840-2088"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEHL",
        "first_name": "BRIANNA",
        "middle_name": "C",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-06-06",
        "last_updated": "2024-12-09",
        "certification_date": "2024-12-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NJ",
            "license": "25MP00486600",
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "NJ",
            "license": "25MP00486600",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "BRIANNA",
            "last_name": "DZIEDZIC",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Brick, NJ

Sources for this page

Verify at the official NPI Registry.