NPIMap

Individual provider Active NPI

Mira Kheny, M.D.

  • Family Medicine Physician
  • Cherry Hill, NJ
National Provider Identifier
1083653521
Registry record updated Apr 13, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
25MA04506900 Issued in NJ
Practice address
1 Brace Rd Ste B2
Cherry Hill, NJ 08034-2600
Phone
(856) 354-2232
Fax
(856) 375-6236
NPI assigned
Jun 6, 2006
Last updated
Apr 13, 2021By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 13, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 25MA04506900 NJ Primary

Addresses

Primary practice location

1 Brace Rd Ste B2
Cherry Hill, NJ 08034-2600

Mailing address

PO Box 1077
Voorhees, NJ 08043-7077
Phone (856) 910-8100

Other practice location 1

5 W Chestnut Ave
Merchantville, NJ 08109-2305
Phone (856) 910-8100

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address mkheny12755@directvirtua.org
Direct Messaging Address mkheny12755@directvirtua.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20101013000839 NJ Practitioner - Family Practice 5496947186 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 1976
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Virtua Medical Group, PAGroup PAC ID 9830222397, 1,678 clinicians

Practice addresses (Care Compare)

1 Brace Rd
Cherry Hill, NJ 08034-2600

3242 Route 206
Bordentown, NJ 08505-4517

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Lower limb (leg) arthroscopy (minimally invasive joint repair)1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
25MA04506900NJMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Virtua Medical Group, PA Family Medicine CurrentSince Jun 28, 2016 Accepting new patients
Virtua Medical Group, PA CurrentSince Jun 28, 2016 Accepting new patients
Virtua Surgical Group, P.a Past Accepting new patients
Virtua - West Jersey Health System, Inc. Past Accepting new patients

Locations

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

1 Brace Rd
Ste B2
Cherry Hill, NJ 08034
Phone (856) 354-2232

305 Route 70 E
Ste A
Cherry Hill, NJ 08034
Phone (856) 375-6243

141 Route 70 E
Ste E
Marlton, NJ 08053
Phone (856) 985-7373

303 Lippincott Dr
Marlton, NJ 08053

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 12

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": "1149552000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1618272000000",
    "number": "1083653521",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1077",
            "city": "VOORHEES",
            "state": "NJ",
            "postal_code": "080437077",
            "telephone_number": "856-910-8100",
            "fax_number": "856-910-8101"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 BRACE RD STE B2",
            "city": "CHERRY HILL",
            "state": "NJ",
            "postal_code": "080342600",
            "telephone_number": "856-354-2232",
            "fax_number": "856-375-6236"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5 W Chestnut Ave",
            "address_purpose": "LOCATION",
            "city": "Merchantville",
            "state": "NJ",
            "postal_code": "081092305",
            "country_code": "US",
            "telephone_number": "856-910-8100",
            "fax_number": "856-910-8101",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KHENY",
        "first_name": "MIRA",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-06-06",
        "last_updated": "2021-04-13",
        "certification_date": "2021-04-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NJ",
            "license": "25MA04506900",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mkheny12755@directvirtua.org",
            "affiliation": "N",
            "address_1": "305 Route 70 E Ste A",
            "city": "Cherry Hill",
            "state": "NJ",
            "country_code": "US",
            "postal_code": "080342408",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mkheny12755@directvirtua.org",
            "affiliation": "N",
            "address_1": "1 Brace Rd Ste B2",
            "city": "Cherry Hill",
            "state": "NJ",
            "country_code": "US",
            "postal_code": "080342600",
            "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.