Virtua Medical Group, PA
Organization Active NPI Urgent Care Clinic/Center · Medford, NJ
NPI 1144770975 · NPPES record last updated Jun 11, 2024
Key facts
- NPI
- 1144770975
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Urgent Care Clinic/Center 261QU0200X
- Legal business name
- VIRTUA MEDICAL GROUP, PA
- Practice address
- 128 Route 70 Ste 1
Medford, NJ 08055-2371 - Phone
- (609) 367-0900
- Fax
- (609) 367-0901
- NPI assigned
- Oct 5, 2016
- Organization subpart
- Yes
- Parent organization (as reported)
- VIRTUA MEDICAL GROUP, PA
Authorized official
- Name
- John Mark Matsinger, DO
- Title
- Evp; Chief Operating Officer
- Phone
- (856) 355-0340
Other NPIs on the same Medicare enrollment 10
Practitioners 147
-
Theresa Bosede Adeliyi, MD, MPH
-
Alyssa Renee Angelino, NURSE PRACTIONER
-
David Arveladze, MD
-
Lawton Cullen Atlee, PA-C
-
Jasmine Bajaj, MD
-
Marie Barseghian, NP
-
Raman Battish, M.D.
-
Chanakya Bavishi, DO
-
Annette Berry, APN
-
Michelle Cifone Bilbao, D.O.
-
Cathy A Boharsik, C.R.N.A.
-
Matthew Kyle Brant, D.P.M
-
Neil M Campbell, DO
-
Laura Chec, DO
-
Christopher Chong, M.D.
-
Brian Paul Colangelo, LCSW, CADC
-
Danielle Lynn Cooley, D.O.
-
Johanna Rosaly Cruz, MSN, APRN, FNP-C
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 31D2104262 | Virtua Urgent Care Medford | Certificate of waiver | Oct 29, 2027 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NJ
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20100804000338 | NJ | Part B Supplier - Clinic/Group Practice | 9830222397 |
Receives reassigned benefits from 2,240 practitioners 13 other NPIs on this enrollment This NPI is an additional NPI on the enrollment |
National Provider Directory
- Part of
- Virtua Medical Group PA
Locations
3242 Route 206
Ste 2
Bordentown, NJ 08505
Phone (609) 298-4340
301 Lippincott Dr
Ste 120
Marlton, NJ 08053
Phone (856) 355-0333
1001 Route 73 N
Uppr
Marlton, NJ 08053
Phone (856) 355-7137
239 Hurffville Crosskeys Rd
Ste 350A
Sewell, NJ 08080
Phone (856) 589-0300
2225 E Evesham Rd
Ste 101A
Voorhees, NJ 08043
Phone (856) 795-4330
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Urgent Care Clinic/Center | 261QU0200X | Yes |
Addresses
Primary practice location
128 Route 70 Ste 1
Medford, NJ 08055-2371
Mailing address
301 Lippincott Dr Ste 410
Marlton, NJ 08053-4197
Phone (856) 355-0340
Other names
- Virtua Urgent Care - Medford
Other providers in Medford, NJ
- Ingrid Vasquez
- Melissa Anne Venturi
- Lawrence Frank Vernamonti
- Naoana Victor
- Valerie Villamil
- Virtua Medical Group, PA
- Voca Corporation of New Jersey
- William John Vonleer
- Marvin Wainwright Jr.
- Charles P Waitz
All providers in Medford, NJ · Urgent Care Clinic/Center in New Jersey
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 11, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.