Active NPI
Nicole Tomkowich, DO
- Anesthesiology Physician
- Mount Holly, NJ
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Anesthesiology Physician
- License
- 25MB11809000
- Practice address
- 175 Madison Ave
Mount Holly, NJ 08060-2099 - Phone
- (609) 914-6000
- NPI assigned
- Jun 14, 2019
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Anesthesiology Physician | 207L00000X | 25MB11809000 | NJ | Primary |
| Student in an Organized Health Care Education/Training Program | 390200000X | OT019399 | PA |
Addresses
Primary practice location
175 Madison Ave
Mount Holly, NJ 08060-2099
Mailing address
301 Lippincott Dr Ste 410
Marlton, NJ 08053-4197
Phone (856) 355-0340
Other practice location 1
500 Lansdowne Avenue
Darby, PA 19023
Phone (610) 237-4000
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Anesthesiology
- Education
- Other, 2019
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
175 Madison Ave
Mount Holly, NJ 08060-2038
Phone (856) 247-7260
Hospital & facility affiliations
- Virtua Mount Holly Hospital
- Virtua Willingboro Hospital
Merit-based Incentive Payment System (MIPS)
- Final score
- 81.15 of 100
- Quality
- 62.28
- Promoting interoperability
- 100
- Improvement activities
- 40
- Cost
- 74.89
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| OT019399 | PA | MD | Student in an Organized Health Care Education/Training Program |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Virtua Medical Group, PA | Current | Accepting new patients | |
| Virtua Medical Group, PA | Anesthesiology | Current | Accepting new patients |
Locations
3242 Route 206
Ste 2
Bordentown, NJ 08505
Phone (609) 298-4340
301 Lippincott Dr
Ste 410
Marlton, NJ 08053
303 Lippincott Dr
Ste 200
Marlton, NJ 08053
Phone (856) 355-0335
175 Madison Ave
Mount Holly, NJ 08060
Phone (609) 261-1660
Interoperability endpoints
- ntomkowich250785@directvirtua.org
Organizations & group practices 2
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.
-
- Orthopaedic Surgery Physician
- Delran, NJ
- NPI 1841087988
Hospital & facility affiliations 2
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Mount Holly, NJ
- NPI 1134125016
-
- General Acute Care Hospital
- Willingboro, NJ
- NPI 1053316844
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1560470400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1703116800000",
"number": "1003476813",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "301 LIPPINCOTT DR STE 410",
"city": "MARLTON",
"state": "NJ",
"postal_code": "080534197",
"telephone_number": "856-355-0340"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "175 MADISON AVE",
"city": "MOUNT HOLLY",
"state": "NJ",
"postal_code": "080602099",
"telephone_number": "609-914-6000"
}
],
"practiceLocations": [
{
"address_1": "500 Lansdowne Avenue",
"address_purpose": "LOCATION",
"city": "Darby",
"state": "PA",
"postal_code": "19023",
"country_code": "US",
"telephone_number": "610-237-4000",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "TOMKOWICH",
"first_name": "NICOLE",
"credential": "DO",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-06-14",
"last_updated": "2023-12-21",
"certification_date": "2023-12-21",
"status": "A"
},
"taxonomies": [
{
"code": "207L00000X",
"taxonomy_group": "",
"desc": "Anesthesiology",
"state": "NJ",
"license": "25MB11809000",
"primary": true
},
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": "PA",
"license": "OT019399",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Mount Holly, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 21, 2023; 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.