Individual provider Active NPI

Dawnmarie Menniti, PA-C

  • Medical Physician Assistant
  • Camden, NJ
National Provider Identifier
1033497839
Registry record updated Aug 21, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
25MP00428200 Issued in NJ
Practice address
1 Cooper PLZ
Camden, NJ 08103
Phone
(856) 342-3150
NPI assigned
Jul 27, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 21, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 25MP00428200 NJ Primary

Addresses

Primary practice location

1 Cooper PLZ
Camden, NJ 08103

Mailing address

1 Federal St # 200
Camden, NJ 08103-1088
Phone (856) 356-4924

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
I20190919002963 NJ Practitioner - Physician Assistant 7315277282 Reassigns benefits to 3 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
25MP00428200NJMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Cooper Surgical Associates, PA CurrentSince Jul 15, 2023 Accepting new patients
CMC Department of Medicine Group PA CurrentSince Jun 30, 2023 Accepting new patients

Locations

1 Federal St
Ste SW200
Camden, NJ 08103
Phone (856) 356-4920

3 Cooper Plz
Rm 104
Camden, NJ 08103
Phone (609) 963-6770

3 Cooper Plz
Rm 411
Camden, NJ 08103
Phone (856) 342-2270

1 Federal St
#200
Camden, NJ 08103

1 Cooper Plz
Camden, NJ 08103
Phone (856) 342-2425

2201 Chapel Ave W
Cherry Hill, NJ 08002
Phone (856) 488-6500

Interoperability endpoints

  • Direct secure messaging: dmenniti88822@direct.cooperhealth.edu

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1311724800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692576000000",
    "number": "1033497839",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 FEDERAL ST # 200",
            "city": "CAMDEN",
            "state": "NJ",
            "postal_code": "081031088",
            "telephone_number": "856-356-4924"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 COOPER PLZ",
            "city": "CAMDEN",
            "state": "NJ",
            "postal_code": "08103",
            "telephone_number": "856-342-3150"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MENNITI",
        "first_name": "DAWNMARIE",
        "name_prefix": "Ms.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-07-27",
        "last_updated": "2023-08-21",
        "certification_date": "2023-08-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NJ",
            "license": "25MP00428200",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Camden, NJ

Sources for this page

Verify at the official NPI Registry.