Individual provider Active NPI

Scott L Siegal, DO

  • Cardiovascular Disease Physician
  • Cherry Hill, NJ
National Provider Identifier
1164416590
Registry record updated May 28, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
MB059456 Issued in NJ
Practice address
1 Brace Road
Suite C
Cherry Hill, NJ 08034-2624
Phone
(856) 482-8900
Fax
(856) 482-8943
NPI assigned
Aug 31, 2005
Last updated
May 28, 2013By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 28, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X MB059456 NJ Primary

Addresses

Primary practice location

1 Brace Road
Suite C
Cherry Hill, NJ 08034-2624

Mailing address

1 Brace Road
Suite C
Cherry Hill, NJ 08034-2624
Phone (856) 482-8900

Other identifiers 1

IdentifierTypeStateIssuer
72258730MedicaidNJ

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
I20040618000599 NJ Practitioner - Cardiovascular Disease (Cardiology) 9931184652 Reassigns benefits to 3 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MB059456NJMDCardiovascular Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Ocean Health Initiatives Inc CurrentSince Sep 1, 2017 Accepting new patients
Professional Service Fund of Deborah Heart & Lung Center CurrentSince Jul 11, 2017 Accepting new patients
Ocean Health Initiatives, Inc CurrentSince Sep 1, 2017 Accepting new patients
Deborah Heart and Lung Center Current Accepting new patients
Deborah Cardiovascular Group, P.C. CurrentSince Jul 11, 2017 Accepting new patients
Professional Service Fund of Deborah- Anesthesia Current Accepting new patients
Hamilton Cardiology Associates, PA Cardiovascular Disease Past Accepting new patients
Lourdes Cardiology Services Cardiovascular Disease Past Accepting new patients
South Jersey Radiology Associates P a Past Accepting new patients
South Jersey Heart Group, PC Cardiovascular Disease PastSince Sep 21, 1993 Accepting new patients

Locations

200 Trenton Rd
Browns Mills, NJ 08015
Phone (609) 893-1200

101 2nd St
Lakewood, NJ 08701
Phone (732) 886-4809

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/11366/brand/2/csg/1/fhir/r4
  • FHIR API: https://fhir-api.fhirprod.aws.greenwayhealth.com/fhir/R4/2.16.840.1.113883.3.441.762
  • Direct secure messaging: medrecs@deborah.medalliesdirect.net

Organizations & group practices 10

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1125446400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1369699200000",
    "number": "1164416590",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 BRACE ROAD",
            "address_2": "SUITE C",
            "city": "CHERRY HILL",
            "state": "NJ",
            "postal_code": "080342624",
            "telephone_number": "856-482-8900",
            "fax_number": "856-482-8943"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 BRACE ROAD",
            "address_2": "SUITE C",
            "city": "CHERRY HILL",
            "state": "NJ",
            "postal_code": "080342624",
            "telephone_number": "856-482-8900",
            "fax_number": "856-482-8943"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIEGAL",
        "first_name": "SCOTT",
        "middle_name": "L",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-31",
        "last_updated": "2013-05-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "NJ",
            "license": "MB059456",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "72258730",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cherry Hill, NJ

Sources for this page

Verify at the official NPI Registry.