Individual provider Active NPI

Stephanie Simonetti, APN

  • Nurse Practitioner
  • Cherry Hill, NJ
National Provider Identifier
1104586031
Registry record updated Oct 1, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
26NJ01237000 Issued in NJ
Practice address
1210 Brace Rd Ste 103
Cherry Hill, NJ 08034-3213
Phone
(856) 536-1515
NPI assigned
Dec 20, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 1, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Medicine Physician 207QA0505X 26NJ01237000 NJ
Nurse Practitioner 363L00000X 26NJ01237000 NJ Primary

Addresses

Primary practice location

1210 Brace Rd Ste 103
Cherry Hill, NJ 08034-3213

Mailing address

1 Federal St Ste 200
Camden, NJ 08103-1088
Phone (848) 288-6935

Other practice location 1

457 Haddonfield Rd Ste 110
Cherry Hill, NJ 08002-2223
Phone (844) 542-2273

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
I20220202000519 NJ Practitioner - Nurse Practitioner 4183017825 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Cooper Care Alliance, PCGroup PAC ID 5890110563, 118 clinicians

Practice addresses (Care Compare)

1210 Brace Rd
Suite 103
Cherry Hill, NJ 08034-3213
Phone (856) 536-1515

Hospital & facility affiliations

  • Bayada Home Health Care, Inc Home health agency, Pennsauken, NJ, CCN 317065
  • Cooper University Hospital Hospital, Camden, NJ, CCN 310014

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
26NJ01237000NJMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Cooper Care Alliance, PC CurrentSince Oct 1, 2024 Accepting new patients
Family Physicians at Burlington Adult Medicine Past Accepting new patients

Locations

1816 Route 541
Ste 102
Burlington, NJ 08016
Phone (609) 747-0870

2339 Route 70 W
Fl 4
Cherry Hill, NJ 08002
Phone (856) 414-6110

1210 Brace Rd
Ste 103
Cherry Hill, NJ 08034
Phone (856) 342-2034

901 Route 168
Ste 210
Turnersville, NJ 08012
Phone (856) 227-1221

Interoperability endpoints

  • Direct secure messaging: ssimonetti191176@direct.cooperhealth.edu

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 6

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": "1639958400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727740800000",
    "number": "1104586031",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 FEDERAL ST STE 200",
            "city": "CAMDEN",
            "state": "NJ",
            "postal_code": "081031088",
            "telephone_number": "848-288-6935",
            "fax_number": "732-790-0107"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1210 BRACE RD STE 103",
            "city": "CHERRY HILL",
            "state": "NJ",
            "postal_code": "080343213",
            "telephone_number": "856-536-1515"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "457 Haddonfield Rd Ste 110",
            "address_purpose": "LOCATION",
            "city": "Cherry Hill",
            "state": "NJ",
            "postal_code": "080022223",
            "country_code": "US",
            "telephone_number": "844-542-2273",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SIMONETTI",
        "first_name": "STEPHANIE",
        "credential": "APN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-12-20",
        "last_updated": "2024-10-01",
        "certification_date": "2024-10-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207QA0505X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Adult Medicine",
            "state": "NJ",
            "license": "26NJ01237000",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NJ",
            "license": "26NJ01237000",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cherry Hill, NJ

Sources for this page

Verify at the official NPI Registry.