Individual provider Active NPI

Kevin Edward Peifer

  • Anesthesiology Physician
  • Mt. Holly, NJ
National Provider Identifier
1023647641
Registry record updated Jul 30, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
25MA12619900 Issued in NJ
Practice address
175 Madison Avenue, 1St Floor
Mt. Holly, NJ 08060
Phone
(609) 914-6000
Fax
(609) 914-6296
NPI assigned
Apr 6, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 30, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Anesthesiology Physician 207L00000X 25MA12619900 NJ Primary

Addresses

Primary practice location

175 Madison Avenue, 1St Floor
Mt. Holly, NJ 08060

Mailing address

301 Lippincott Dr Ste 410
Marlton, NJ 08053-4197
Phone (609) 914-6000

Other practice location 1

263 Farmington Ave
Farmington, CT 06030-0001
Phone (860) 679-3600

Other practice location 2

218 Sunset Road Floor 2
Willingboro, NJ 08046
Phone (609) 835-2900

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address kpeifer304054@directvirtua.org Direct
Direct Messaging Address kpeifer304054@directvirtua.org Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA, NJ2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20240916001743 PA Practitioner - Anesthesiology 1850832098
I20250527000097 NJ Practitioner - Anesthesiology 1850832098 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
Philadelphia College of Osteopathic Medicine, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Virtua Medical Group, PAGroup PAC ID 9830222397, 1,678 clinicians

Practice addresses (Care Compare)

175 Madison Ave
Mount Holly, NJ 08060-2038

218 Sunset Rd
FL 5
Willingboro, NJ 08046-1110
Phone (609) 444-0359

3242 Route 206
Bordentown, NJ 08505-4517

Hospital & facility affiliations

  • Virtua Mount Holly Hospital Hospital, Mount Holly, NJ, CCN 310057
  • Virtua Willingboro Hospital Hospital, Willingboro, NJ, CCN 310061

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
25MA12619900NJMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Virtua Medical Group, PA CurrentSince Jul 1, 2025 Accepting new patients
Virtua Medical Group, PA Anesthesiology CurrentSince Jul 1, 2025 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
Fl 1
Mount Holly, NJ 08060
Phone (609) 914-6000

218 Sunset Rd
Fl 2
Willingboro, NJ 08046
Phone (609) 444-0599

Interoperability endpoints

  • Direct secure messaging: kpeifer304054@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.

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": "1586131200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1753833600000",
    "number": "1023647641",
    "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": "609-914-6000",
            "fax_number": "609-914-6296"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "175 MADISON AVENUE, 1ST FLOOR",
            "city": "MT. HOLLY",
            "state": "NJ",
            "postal_code": "08060",
            "telephone_number": "609-914-6000",
            "fax_number": "609-914-6296"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "263 Farmington Ave",
            "address_purpose": "LOCATION",
            "city": "Farmington",
            "state": "CT",
            "postal_code": "060300001",
            "country_code": "US",
            "telephone_number": "860-679-3600",
            "fax_number": "860-679-1275",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "218 Sunset Road Floor 2",
            "address_purpose": "LOCATION",
            "city": "Willingboro",
            "state": "NJ",
            "postal_code": "08046",
            "country_code": "US",
            "telephone_number": "609-835-2900",
            "fax_number": "609-444-0111",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PEIFER",
        "first_name": "KEVIN",
        "middle_name": "EDWARD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-04-06",
        "last_updated": "2025-07-30",
        "certification_date": "2025-07-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "NJ",
            "license": "25MA12619900",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kpeifer304054@directvirtua.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "218 Sunset Road Floor 2",
            "city": "Willingboro",
            "state": "NJ",
            "country_code": "US",
            "postal_code": "08046",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kpeifer304054@directvirtua.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "175 Madison Avenue, 1st Floor",
            "city": "Mt. Holly",
            "state": "NJ",
            "country_code": "US",
            "postal_code": "08060",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Mt. Holly, NJ

Sources for this page

Verify at the official NPI Registry.