Modern Spine and Pain PC

Primary specialty

Pain Medicine PhysicianTaxonomy code 208VP0000X

Legal business name

MODERN SPINE AND PAIN PC

Practice address

196 Grove Ave Ste E
West Deptford, NJ 08086-2139

Phone

(856) 900-0041

NPI assigned

Oct 27, 2022

Organization subpart

No

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

Authorized official

Name

Amanda L Ricca

Title

Administrator

Phone

(215) 651-8180

Specialties & licenses 4

Addresses

Medicare fee-for-service enrollment

Enrolled in NJ

Enrollment records 1

Locations

Practitioners 3

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

• Youssef Josephson, D.O

  • Interventional Pain Medicine Physician
  • West Deptford, NJ
  • NPI 1598928608
  Medicare reassignment Care Compare group NPD
• Yadira Pena, PA-C

  • Physician Assistant
  • Babylon, NY
  • NPI 1093067514

  NJ

  Medicare reassignment Care Compare group
• Chelsea Lynne Crosby, APRN

  • Nurse Practitioner
  • Moorestown, NJ
  • NPI 1538756432
  Medicare reassignment NPD

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

{
    "created_epoch": "1666828800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1677196800000",
    "number": "1174240352",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 358",
            "city": "DOUGLASSVILLE",
            "state": "PA",
            "postal_code": "195180358"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "196 GROVE AVE STE E",
            "city": "WEST DEPTFORD",
            "state": "NJ",
            "postal_code": "080862139",
            "telephone_number": "856-900-0041"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MODERN SPINE AND PAIN PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-10-27",
        "last_updated": "2023-02-24",
        "certification_date": "2023-02-24",
        "status": "A",
        "authorized_official_last_name": "RICCA",
        "authorized_official_first_name": "AMANDA",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "215-651-8180"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2081P2900X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Medicine & Rehabilitation, Pain Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208VP0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pain Medicine, Pain Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "208VP0014X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pain Medicine, Interventional Pain Medicine",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Joseph Anthony Megara III, DPM
• Louis P Melchiorre Jr., MD
• Hossam H Messiha, RPH.
• Michael S Rogers MD PA
• Anthony N Mishik, MD
• Michael Montanero
• Steven R Moraca, PSY.D.
• Brittany Morina
• Caitlin Ann Moya, MSW, LCSW
• Julie Moyer, LCSW

• Pain Medicine Physician in West Deptford, NJ
• Providers in West Deptford, NJ by specialty
• Pain Medicine Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 2023; 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.