Individual provider Active NPI

Mary August Olsson

  • Physician Assistant
  • Cherry Hill, NJ
National Provider Identifier
1023708567
Registry record updated Nov 20, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
25MP00782800 Issued in NJ
Practice address
1945 Route 70 E Ste D
Cherry Hill, NJ 08003-2160
Phone
(856) 237-8045
NPI assigned
May 9, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 20, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 25MP00782800 NJ Primary

Addresses

Primary practice location

1945 Route 70 E Ste D
Cherry Hill, NJ 08003-2160

Mailing address

1945 Route 70 E Ste D
Cherry Hill, NJ 08003-2160
Phone (856) 237-8045

Other identifiers 1

IdentifierTypeStateIssuer
0953181MedicaidNJ

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address molsson257830@directvirtua.org

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20231019001238 NJ Practitioner - Physician Assistant 1153777669 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2023
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)

100 Bowman Dr
Voorhees, NJ 08043-9612
Phone (856) 247-7260

1600 Haddon Ave
Camden, NJ 08103-3101

3242 Route 206
Bordentown, NJ 08505-4517

90 Brick Rd
Marlton, NJ 08053-2177
Phone (856) 247-7260

Hospital & facility affiliations

  • West Jersey Hospital Hospital, Voorhees, NJ, CCN 310022
  • Virtua Our Lady of Lourdes Hospital Hospital, Camden, NJ, CCN 310029

Merit-based Incentive Payment System (MIPS)

Final score
81.15 of 100Reported as group
Quality
62.28
Promoting interoperability
100
Improvement activities
40
Cost
74.89

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Virtua Medical Group, PA CurrentSince Aug 21, 2023 Accepting new patients
Virtua Medical Group, PA Physician Assistant CurrentSince Aug 21, 2023 Accepting new patients
Virtua Medical Group, PA Past Accepting new patients

Locations

3242 Route 206
Ste 2
Bordentown, NJ 08505
Phone (609) 298-4340

1945 Route 70 E
Ste D
Cherry Hill, NJ 08003

303 Lippincott Dr
Ste 200
Marlton, NJ 08053
Phone (856) 355-0335

Interoperability endpoints

  • Direct secure messaging: molsson257830@directvirtua.org

Organizations & group practices 3

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": "1683590400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1732060800000",
    "number": "1023708567",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1945 ROUTE 70 E STE D",
            "city": "CHERRY HILL",
            "state": "NJ",
            "postal_code": "080032160",
            "telephone_number": "856-237-8045",
            "fax_number": "856-237-8047"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1945 ROUTE 70 E STE D",
            "city": "CHERRY HILL",
            "state": "NJ",
            "postal_code": "080032160",
            "telephone_number": "856-237-8045"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OLSSON",
        "first_name": "MARY AUGUST",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-05-09",
        "last_updated": "2024-11-20",
        "certification_date": "2024-11-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NJ",
            "license": "25MP00782800",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0953181",
            "state": "NJ"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "molsson257830@directvirtua.org",
            "affiliation": "N",
            "address_1": "1945 Route 70 E Ste D",
            "city": "Cherry Hill",
            "state": "NJ",
            "country_code": "US",
            "postal_code": "080032160",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Cherry Hill, NJ

Sources for this page

Verify at the official NPI Registry.