Individual provider Active NPI

Domenica Caporusso, RD

  • Registered Dietitian
  • Sewell, NJ
National Provider Identifier
1104562990
Registry record updated Oct 30, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
Practice address
239 Hurffville Crosskeys Rd Ste 360B
Sewell, NJ 08080-4002
Phone
(856) 341-8250
Fax
(856) 341-8251
NPI assigned
May 5, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 30, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X Primary

Addresses

Primary practice location

239 Hurffville Crosskeys Rd Ste 360B
Sewell, NJ 08080-4002

Mailing address

301 Lippincott Dr Ste 410
Marlton, NJ 08053-4197
Phone (856) 341-8250

Other practice location 1

200 Bowman Dr Ste E385D
Voorhees, NJ 08043-9623
Phone (856) 341-8250

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address dcaporusso312264@directvirtua.org Direct
Direct Messaging Address dcaporusso312264@directvirtua.org Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250604004165 NJ Practitioner - Registered Dietitian Or Nutrition Professional 9830608389 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Registered Dietitian Or Nutrition Professional
Education
Other, 2016
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)

239 Hurffville Crosskeys Rd
Suite 360B
Sewell, NJ 08080-4002
Phone (856) 237-8045

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Virtua Medical Group, PA CurrentSince Aug 1, 2025 Accepting new patients
Virtua Medical Group, PA CurrentSince Aug 1, 2025 Accepting new patients
Virtua Medical Group, PA 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

239 Hurffville Crosskeys Rd
Ste 360B
Sewell, NJ 08080

200 Bowman Dr
Ste E385D
Voorhees, NJ 08043
Phone (856) 325-4270

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.

NPI Registry JSON

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

{
    "created_epoch": "1651708800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1761782400000",
    "number": "1104562990",
    "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": "856-341-8250",
            "fax_number": "856-341-8251"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "239 HURFFVILLE CROSSKEYS RD STE 360B",
            "city": "SEWELL",
            "state": "NJ",
            "postal_code": "080804002",
            "telephone_number": "856-341-8250",
            "fax_number": "856-341-8251"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "200 Bowman Dr Ste E385D",
            "address_purpose": "LOCATION",
            "city": "Voorhees",
            "state": "NJ",
            "postal_code": "080439623",
            "country_code": "US",
            "telephone_number": "856-341-8250",
            "fax_number": "856-341-8251",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CAPORUSSO",
        "first_name": "DOMENICA",
        "credential": "RD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-05-05",
        "last_updated": "2025-10-30",
        "certification_date": "2025-10-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "dcaporusso312264@directvirtua.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "200 Bowman Dr Ste E385D",
            "city": "Voorhees",
            "state": "NJ",
            "country_code": "US",
            "postal_code": "080439623",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "dcaporusso312264@directvirtua.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "239 Hurffville Crosskeys Rd Ste 360B",
            "city": "Sewell",
            "state": "NJ",
            "country_code": "US",
            "postal_code": "080804002",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Sewell, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.

Verify at the official NPI Registry.