Individual provider Active NPI

Diana Fibison, M.D.

  • Family Medicine Physician
  • Clifton, NJ
National Provider Identifier
1932479706
Registry record updated Jan 10, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
25MA09781800 Issued in NJ
Practice address
533 Lexington Ave
Clifton, NJ 07011-1923
Phone
(973) 546-6844
Fax
(973) 546-7707
NPI assigned
Jan 10, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 10, 2017

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 25MA09781800 NJ Primary

Addresses

Primary practice location

533 Lexington Ave
Clifton, NJ 07011-1923

Mailing address

533 Lexington Ave
Clifton, NJ 07011-1923
Phone (973) 546-6844

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
I20160218000527 NJ Practitioner - Family Practice 0143525881 Reassigns benefits to 4 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
25MA09781800NJMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Sovereign Medical Group, LLC CurrentSince Sep 1, 2018 Accepting new patients
Ritu Suri MD, LLC CurrentSince Sep 17, 2019 Accepting new patients
Sovereign Medical Group LLC CurrentSince Sep 1, 2018 Accepting new patients
BHMG - United Medical Family Medicine CurrentSince Feb 18, 2017 Accepting new patients
Somc Medical Group PC CurrentSince Feb 1, 2016 Accepting new patients
Ocean County Family Care, P.a. Current Accepting new patients

Locations

2125 Route 88 E
Brick, NJ 08724
Phone (732) 892-4548

630 Broad St
#2
Carlstadt, NJ 07072
Phone (201) 985-8967

533 Lexington Ave
Clifton, NJ 07011
Phone (973) 546-6844

245 Engle St
Englewood, NJ 07631
Phone (201) 568-0770

85 Harristown Rd
Fl 2
Glen Rock, NJ 07452
Phone (201) 703-5500

27 S Cooks Bridge Rd
Ste 1-4
Jackson, NJ 08527
Phone (732) 364-3881

612 Rutherford Ave
Lyndhurst, NJ 07071
Phone (200) 460-0063

680 Kinderkamack Rd
Ste 300
Oradell, NJ 07649
Phone (201) 881-7869

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": "1326153600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1484006400000",
    "number": "1932479706",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "533 LEXINGTON AVE",
            "city": "CLIFTON",
            "state": "NJ",
            "postal_code": "070111923",
            "telephone_number": "973-546-6844",
            "fax_number": "973-546-7707"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "533 LEXINGTON AVE",
            "city": "CLIFTON",
            "state": "NJ",
            "postal_code": "070111923",
            "telephone_number": "973-546-6844",
            "fax_number": "973-546-7707"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FIBISON",
        "first_name": "DIANA",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-01-10",
        "last_updated": "2017-01-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NJ",
            "license": "25MA09781800",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clifton, NJ

Sources for this page

Verify at the official NPI Registry.