Individual provider Active NPI

Beverly Roeckel

  • Gerontology Nurse Practitioner
  • Browns Mills, NJ
National Provider Identifier
1164978276
Registry record updated Aug 29, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Nurse PractitionerTaxonomy code 363LG0600X
License
26NJ00648300 Issued in NJ
Practice address
200 Trenton Rd
Browns Mills, NJ 08015-1705
Phone
(609) 893-6611
Fax
(609) 735-0415
NPI assigned
Aug 29, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 29, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gerontology Nurse Practitioner 363LG0600X 26NJ00648300 NJ Primary

Addresses

Primary practice location

200 Trenton Rd
Browns Mills, NJ 08015-1705

Mailing address

Deborah Heart and Lung Center 200 Trenton Road
Browns Mills, NJ 08015
Phone (609) 893-6611

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
I20161011001866 NJ Practitioner - Nurse Practitioner 1658669452 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
84.63 of 100Reported as group
Quality
72.06
Improvement activities
40
Cost
72.92

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Professional Service Fund of Deborah- Anesthesia Current Accepting new patients
Samaritan Healthcare & Hospice, Inc. CurrentSince Apr 1, 2022 Accepting new patients
Professional Service Fund of Deborah Heart & Lung Center CurrentSince Aug 13, 2016 Accepting new patients

Locations

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

3906 Church Rd
#P
Mount Laurel, NJ 08054
Phone (856) 552-3261

3906 Church Rd
Mount Laurel, NJ 08054
Phone (856) 222-3292

Organizations & group practices 3

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": "1472428800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1472428800000",
    "number": "1164978276",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "DEBORAH HEART AND LUNG CENTER 200 TRENTON ROAD",
            "city": "BROWNS MILLS",
            "state": "NJ",
            "postal_code": "08015",
            "telephone_number": "609-893-6611",
            "fax_number": "609-735-0415"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 TRENTON RD",
            "city": "BROWNS MILLS",
            "state": "NJ",
            "postal_code": "080151705",
            "telephone_number": "609-893-6611",
            "fax_number": "609-735-0415"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROECKEL",
        "first_name": "BEVERLY",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-08-29",
        "last_updated": "2016-08-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "NJ",
            "license": "26NJ00648300",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Browns Mills, NJ

Sources for this page

Verify at the official NPI Registry.