Diane M. Mustafa, M.D.

Primary specialty

Gynecology PhysicianTaxonomy code 207VG0400X

License

25MA09377500 Issued in NJ

Practice address

916 Main Ave Ste 2C
Passaic, NJ 07055-8545

Phone

(973) 200-2794

Fax

(973) 777-9405

NPI assigned

Sep 24, 2011

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Other names 1

• Mrs. Diane M. Bamgbade Former name

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

Specialty

Obstetrics/Gynecology

Education

Rutgers, Robert Woood Johnson Medical School, 2009

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Practice Associates Medical GroupGroup PAC ID 5890703177, 1,412 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• St Joseph'S University Medical Center Inc Hospital, Paterson, NJ, CCN 310019

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/21692/brand/1/csg/1/fhir/r4
• Direct secure messaging: dmustafa104378@epicdirect.rwjbh.org

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.

• Practice Associates Medical Group

  • Internal Medicine Physician
  • Morristown, NJ
  • NPI 1427016385

  Obstetrics & Gynecology

  Medicare reassignment Care Compare group NPD
• Barnabas Health Medical Group PC

  • Specialist
  • Elizabeth, NJ
  • NPI 1841557246
  Medicare reassignment NPD
• Jersey Women'S Care Center, Inc

  • Specialist
  • Jersey City, NJ
  • NPI 1184964892
  Medicare reassignment NPD
• Living Springs Women'S Care, LLC

  • Obstetrics Physician
  • Passaic, NJ
  • NPI 1114545241
  Medicare reassignment NPD
• Womens Health of New Jersey LLC

  • Obstetrics & Gynecology Physician
  • Paterson, NJ
  • NPI 1578941886
  Medicare reassignment NPD
• Barnabas Health Medical Group PC

  • Durable Medical Equipment & Medical Supplies
  • Hackensack, NJ
  • NPI 1316772668
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• St Josephs University Medical Center Inc.

  • General Acute Care Hospital
  • Paterson, NJ
  • NPI 1669462420
  Care Compare affiliation

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

{
    "created_epoch": "1316822400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1583971200000",
    "number": "1992088082",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "916 MAIN AVE STE 2C",
            "city": "PASSAIC",
            "state": "NJ",
            "postal_code": "070558545",
            "telephone_number": "973-200-2794",
            "fax_number": "973-777-9405"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "916 MAIN AVE STE 2C",
            "city": "PASSAIC",
            "state": "NJ",
            "postal_code": "070558545",
            "telephone_number": "973-200-2794",
            "fax_number": "973-777-9405"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MUSTAFA",
        "first_name": "DIANE",
        "middle_name": "M.",
        "name_prefix": "Mrs.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-09-24",
        "last_updated": "2020-03-12",
        "certification_date": "2020-03-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207VG0400X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Gynecology",
            "state": "NJ",
            "license": "25MA09377500",
            "primary": true
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "NJ",
            "license": "25MA09377500",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DIANE",
            "last_name": "BAMGBADE",
            "middle_name": "M.",
            "prefix": "MRS.",
            "credential": "M.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Nilsy Munoz, AS COUNSELING MINIST
• Ryan Murray
• Sunitha Murthy, DDS
• Chana Muschel, DPT
• Zelda Mushel
• Mwmindworks, LLC
• My Therapy Clubhouse
• Chaim Nadborny, D.O.
• Ramona Nadres
• Suprema Dancel Naim, MD

• Gynecology Physician in Passaic, NJ
• Providers in Passaic, NJ by specialty
• Gynecology Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 12, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.