Individual provider Active NPI

Maureen E Snyder, A.P.N.

  • Nurse Practitioner
  • Marmora, NJ
National Provider Identifier
1124384433
Registry record updated Jun 19, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
26NJ00345200 Issued in NJ
Practice address
4 W Roosevelt Blvd Ste 11&12
Marmora, NJ 08223-1441
Phone
(609) 814-9550
NPI assigned
Apr 11, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 19, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 26NJ00345200 NJ Primary

Addresses

Primary practice location

4 W Roosevelt Blvd Ste 11&12
Marmora, NJ 08223-1441

Mailing address

4 W Roosevelt Blvd Ste 11&12
Marmora, NJ 08223-1441
Phone (609) 814-9550

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
I20120618000652 NJ Practitioner - Nurse Practitioner 9234393539 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Shore Memorial Physicians Group PCGroup PAC ID 4688845191, 25 clinicians

Practice addresses (Care Compare)

2605 Shore Rd
Northfield, NJ 08225-2136
Phone (609) 365-5300

4 W Roosevelt Blvd
Marmora, NJ 08223-1441
Phone (609) 814-9550

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
26NJ00345200NJMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Atlanticare Physician Group PA Current Accepting new patients
Shore Memorial Physicians Group PC CurrentSince Sep 11, 2017 Accepting new patients
Atlanticare Physician Group, PA CurrentSince Mar 1, 2013 Accepting new patients
Atlanticare Physician Group CurrentSince Mar 1, 2013 Accepting new patients

Locations

436 Chris Gaupp Dr
Ste 204
Galloway, NJ 08205
Phone (609) 652-0100

459 Route 9 S
Little Egg Harbor Twp, NJ 08087
Phone (609) 340-7815

4 W Roosevelt Blvd
Ste 1112
Marmora, NJ 08223
Phone (609) 814-9550

2605 Shore Rd
Northfield, NJ 08225
Phone (609) 365-5300

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/4024/brand/1/csg/22/fhir/r4

Organizations & group practices 4

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": "1334102400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687132800000",
    "number": "1124384433",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4 W ROOSEVELT BLVD STE 11&12",
            "city": "MARMORA",
            "state": "NJ",
            "postal_code": "082231441",
            "telephone_number": "609-814-9550"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4 W ROOSEVELT BLVD STE 11&12",
            "city": "MARMORA",
            "state": "NJ",
            "postal_code": "082231441",
            "telephone_number": "609-814-9550"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SNYDER",
        "first_name": "MAUREEN",
        "middle_name": "E",
        "credential": "A.P.N.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-04-11",
        "last_updated": "2023-06-19",
        "certification_date": "2023-06-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NJ",
            "license": "26NJ00345200",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Marmora, NJ

Sources for this page

Verify at the official NPI Registry.