Diana R. Decosimo, M.D.

Primary specialty

Geriatric Medicine (Internal Medicine) PhysicianTaxonomy code 207RG0300X

License

25MA06131700 Issued in NJ

Practice address

90 Bergen St
Doc 4400
Newark, NJ 07103-2425

Phone

(973) 972-1880

Fax

(973) 972-1879

NPI assigned

Jul 11, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

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.

• University Physician Associates of New Jersey Inc

  • Family Medicine Physician
  • Newark, NJ
  • NPI 1467462168
  NPD (past)
• University Physician Associates of New Jersey Inc

  • Internal Medicine Physician
  • Newark, NJ
  • NPI 1760492367
  NPD (past)

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

{
    "created_epoch": "1152576000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1251331200000",
    "number": "1962437731",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30 BERGEN ST",
            "address_2": "ADMC 12 1205",
            "city": "NEWARK",
            "state": "NJ",
            "postal_code": "071073000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "90 BERGEN ST",
            "address_2": "DOC 4400",
            "city": "NEWARK",
            "state": "NJ",
            "postal_code": "071032425",
            "telephone_number": "973-972-1880",
            "fax_number": "973-972-1879"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DECOSIMO",
        "first_name": "DIANA",
        "middle_name": "R.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-11",
        "last_updated": "2009-08-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "NJ",
            "license": "25MA06131700",
            "primary": false
        },
        {
            "code": "207RG0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Geriatric Medicine",
            "state": "NJ",
            "license": "25MA06131700",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6326200",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Krishan Hirun De Silva, MD
• Jermaine Ricardo Deacon, MD
• Pratik Deb, MBBS, PHD
• Emma Debenedetto, CRNA
• Justin Deberardinis
• Jacqueline Decunzo, ANP
• Deyaa Deek, MD
• Nicklaus Deevers
• Augustina Christine Defoe, APN, MSN
• Joseph Defrank Castro, MD

• Geriatric Medicine (Internal Medicine) Physician in Newark, NJ
• Providers in Newark, NJ by specialty
• Geriatric Medicine (Internal Medicine) Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 2009; 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.