Individual provider Active NPI

Shelly Robin Schneider, APN,C

  • Adult Health Nurse Practitioner
  • Woodbury, NJ
National Provider Identifier
1124003017
Registry record updated Jul 10, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
26NO074370000 Issued in NJ
Practice address
17 W Red Bank Ave
Suite 205
Woodbury, NJ 08096-1630
Phone
(856) 853-0900
Fax
(856) 853-5838
NPI assigned
Dec 13, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 10, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X 26NO074370000 NJ Primary

Addresses

Primary practice location

17 W Red Bank Ave
Suite 205
Woodbury, NJ 08096-1630

Mailing address

13 Stokes Ave
Voorhees, NJ 08043-4788
Phone (856) 853-0900

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
I20040223000509 NJ Practitioner - Nurse Practitioner 7315833977 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Grace U Chung MD PCGroup PAC ID 5597710707, 5 clinicians

Practice addresses (Care Compare)

500 Grove St
Suite 200
Haddon Heights, NJ 08035-1752
Phone (856) 853-0900

Merit-based Incentive Payment System (MIPS)

Final score
94.79 of 100Reported as individual
Quality
90.54
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
26NO074370000NJMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Grace U Chung MD PC CurrentSince Jul 2, 2010 Accepting new patients
Rami E Geffner MD PA Past Accepting new patients
Coyle S Connolly DO PA PastSince Mar 15, 2002 Accepting new patients

Locations

500 Grove St
Ste 200
Haddon Hgts, NJ 08035
Phone (856) 796-9200

17 W Red Bank Ave
Ste 205
Woodbury, NJ 08096
Phone (856) 853-0900

Interoperability endpoints

  • Direct secure messaging: schneider@premierdermatologynj.emadirect.md

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": "1134432000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1373414400000",
    "number": "1124003017",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13 STOKES AVE",
            "city": "VOORHEES",
            "state": "NJ",
            "postal_code": "080434788",
            "telephone_number": "856-853-0900",
            "fax_number": "856-853-5838"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17 W RED BANK AVE",
            "address_2": "SUITE 205",
            "city": "WOODBURY",
            "state": "NJ",
            "postal_code": "080961630",
            "telephone_number": "856-853-0900",
            "fax_number": "856-853-5838"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHNEIDER",
        "first_name": "SHELLY",
        "middle_name": "ROBIN",
        "name_prefix": "Mrs.",
        "credential": "APN,C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-12-13",
        "last_updated": "2013-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NJ",
            "license": "26NO074370000",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Woodbury, NJ

Sources for this page

Verify at the official NPI Registry.