Organization Active NPI

Optimum Personal Care Physicians LLC

  • Hospice and Palliative Medicine (Family Medicine) Physician
  • Marlton, NJ
National Provider Identifier
1134610967
Registry record updated Oct 10, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospice and Palliative Medicine (Family Medicine) PhysicianTaxonomy code 207QH0002X
Legal business name
OPTIMUM PERSONAL CARE PHYSICIANS LLC
Practice address
538 Lippincott Dr BLDG E
Marlton, NJ 08053
Phone
(856) 489-0503
Fax
(856) 616-9259
NPI assigned
May 29, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 10, 2022

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

Authorized official

Name
Mark TestaNPI 1043205370
Title
Owner
Phone
(215) 990-2145

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X
Hospice and Palliative Medicine (Family Medicine) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207QH0002X Primary

Addresses

Primary practice location

538 Lippincott Dr BLDG E
Marlton, NJ 08053

Mailing address

538 Lippincott Dr BLDG E
Marlton, NJ 08053-4806
Phone (856) 489-0503

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ, PA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20180821003359 NJ Part B Supplier - Clinic/Group Practice 9830448026 Receives reassigned benefits from 1 practitioner
Practice locations: Voorhees, NJ
O20220517000854 PA Part B Supplier - Clinic/Group Practice 9830448026 Receives reassigned benefits from 1 practitioner
Practice locations: Philadelphia, PA

National Provider Directory

National Provider Directory

Locations

1256 Haddonfield Berlin Rd
Voorhees, NJ 08043
Phone (215) 990-2157

Practitioners & affiliated clinicians

Practitioners 15

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1527552000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1665360000000",
    "number": "1134610967",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "538 LIPPINCOTT DR BLDG E",
            "city": "MARLTON",
            "state": "NJ",
            "postal_code": "080534806",
            "telephone_number": "856-489-0503",
            "fax_number": "856-616-9259"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "538 LIPPINCOTT DR BLDG E",
            "city": "MARLTON",
            "state": "NJ",
            "postal_code": "08053",
            "telephone_number": "856-489-0503",
            "fax_number": "856-616-9259"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OPTIMUM PERSONAL CARE PHYSICIANS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-05-29",
        "last_updated": "2022-10-10",
        "certification_date": "2022-10-10",
        "status": "A",
        "authorized_official_last_name": "TESTA",
        "authorized_official_first_name": "MARK",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "215-990-2145"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207QH0002X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine, Hospice and Palliative Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Marlton, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.