Individual provider Active NPI

Claudine De Dan, MD

  • Family Medicine Physician
  • Mullica Hill, NJ
National Provider Identifier
1124058367
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
25MA07871700 Issued in NJ
Practice address
34 Colson LN Ste B
Mullica Hill, NJ 08062-1502
Phone
(856) 628-8120
Fax
(856) 682-8123
NPI assigned
Jul 4, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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 25MA07871700 NJ Primary

Addresses

Primary practice location

34 Colson LN Ste B
Mullica Hill, NJ 08062-1502

Mailing address

34 Colson LN Ste B
Mullica Hill, NJ 08062-1502
Phone (856) 628-8120

Other practice location 1

570 Egg Harbor Rd
Ste C2
Sewell, NJ 08080-2359
Phone (856) 218-0300

Other identifiers 1

IdentifierTypeStateIssuer
0318612MedicaidNJ

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060207000769 NJ Practitioner - Family Practice 2769401058 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Rutgers R W Johnson Medical School (Cam/New Bruns/Pisc), 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

34 Colson LN
Suite B
Mullica Hill, NJ 08062-1502
Phone (856) 628-8120

Hospital & facility affiliations

  • Inspira Medical Center Mullica Hill Hospital, Elmer, NJ, CCN 310069

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Claudine M de Dan MD LLC Family Medicine CurrentSince Aug 31, 2017 Accepting new patients
Rowansom Dept of Pediatrics PastSince Mar 14, 2016 Accepting new patients

Locations

34 Colson Ln
#B
Mullica Hill, NJ 08062
Phone (856) 628-8120

Interoperability endpoints

  • Direct secure messaging: claudine.de.dan.1@16876.direct.athenahealth.com

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 3

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": "1151971200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1124058367",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "34 COLSON LN STE B",
            "city": "MULLICA HILL",
            "state": "NJ",
            "postal_code": "080621502",
            "telephone_number": "856-628-8120",
            "fax_number": "856-682-8123"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "34 COLSON LN STE B",
            "city": "MULLICA HILL",
            "state": "NJ",
            "postal_code": "080621502",
            "telephone_number": "856-628-8120",
            "fax_number": "856-682-8123"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "570 EGG HARBOR RD",
            "address_2": "STE C2",
            "address_purpose": "LOCATION",
            "city": "SEWELL",
            "state": "NJ",
            "postal_code": "080802359",
            "country_code": "US",
            "telephone_number": "856-218-0300",
            "fax_number": "856-853-2122",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DE DAN",
        "first_name": "CLAUDINE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-04",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NJ",
            "license": "25MA07871700",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0318612",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mullica Hill, NJ

Sources for this page

Verify at the official NPI Registry.