Individual provider Active NPI

Brian Paul Colangelo, LCSW, CADC

  • Clinical Social Worker
  • Voorhees, NJ
National Provider Identifier
1114169794
Registry record updated Sep 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
44SC05390100 Issued in NJ
Practice address
1605 E Evesham Rd Ste 200B
Voorhees, NJ 08043-1437
Phone
(856) 322-3110
Fax
(856) 322-3111
NPI assigned
Mar 30, 2009
Last updated
Sep 3, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 3, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 37CA00097500 NJ
Clinical Social Worker 1041C0700X 44SC05390100 NJ Primary

Addresses

Primary practice location

1605 E Evesham Rd Ste 200B
Voorhees, NJ 08043-1437

Mailing address

301 Lippincott Dr Ste 410
Marlton, NJ 08053-4197
Phone (856) 355-0340

Other identifiers 3

IdentifierTypeStateIssuer
1861969218OtherNJBRAVO
91003022600OtherNJUHCCP
3739827000OtherNJMAGELLAN

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address bcolangelo218486@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: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200528000411 NJ Practitioner - Clinical Social Worker 9830510957 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2001
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)

2309 E Evesham Rd
Voorhees, NJ 08043-1559

3242 Route 206
Bordentown, NJ 08505-4517

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

State licenses

LicenseStateTypeSpecialty
37CA00097500NJMDAddiction (Substance Use Disorder) Counselor
44SC05390100NJMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Virtua Medical Group, PA CurrentSince Jan 24, 2022 Accepting new patients
CMC Department of Medicine Group PA CurrentSince May 1, 2020 Accepting new patients
CMC Department of Medicine Group PA CurrentSince May 1, 2020 Accepting new patients
Virtua Medical Group, PA Current Accepting new patients
Virtua Medical Group, PA CurrentSince Jan 24, 2022 Accepting new patients
Project H.O.P.E., Inc. Past Accepting new patients

Locations

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

1 Federal St
#200
Camden, NJ 08103

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

3 Cooper Plz
Rm 215
Camden, NJ 08103
Phone (856) 342-2439

3 Cooper Plz
Rm 220
Camden, NJ 08103
Phone (856) 342-2228

3 Cooper Plz
Rm 311
Camden, NJ 08103
Phone (856) 342-2034

301 Lippincott Dr
Ste 410
Marlton, NJ 08053

401 Young Ave
Ste 260B
Moorestown, NJ 08057

1605 E Evesham Rd
Ste 200B
Voorhees, NJ 08043
Phone (856) 322-3110

Organizations & group practices 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1238371200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1725321600000",
    "number": "1114169794",
    "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": "856-355-0340",
            "fax_number": "856-355-0330"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1605 E EVESHAM RD STE 200B",
            "city": "VOORHEES",
            "state": "NJ",
            "postal_code": "080431437",
            "telephone_number": "856-322-3110",
            "fax_number": "856-322-3111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COLANGELO",
        "first_name": "BRIAN",
        "middle_name": "PAUL",
        "name_prefix": "Mr.",
        "credential": "LCSW, CADC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-03-30",
        "last_updated": "2024-09-03",
        "certification_date": "2024-09-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NJ",
            "license": "37CA00097500",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NJ",
            "license": "44SC05390100",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BRAVO",
            "identifier": "1861969218",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UHCCP",
            "identifier": "91003022600",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MAGELLAN",
            "identifier": "3739827000",
            "state": "NJ"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "bcolangelo218486@directvirtua.org",
            "affiliation": "N",
            "address_1": "1605 E Evesham Rd Ste 200B",
            "city": "Voorhees",
            "state": "NJ",
            "country_code": "US",
            "postal_code": "080431437",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Voorhees, NJ

Sources for this page

Verify at the official NPI Registry.