Active NPI
Marilyn Irene Spagnol, PA-C
- Physician Assistant
- Philadelphia, PA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 25MP00371600
- Practice address
- 5501 Old York Rd
Philadelphia, PA 19141-3018 - Phone
- (215) 456-6560
- NPI assigned
- Jun 22, 2015
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Medical Physician Assistant | 363AM0700X | MA057625 | PA | |
| Physician Assistant | 363A00000X | 25MP00371600 | NJ | Primary |
Addresses
Primary practice location
5501 Old York Rd
Philadelphia, PA 19141-3018
Mailing address
1616 County Line Rd
Chalfont, PA 18914-1201
Phone (215) 589-0262
Other practice location 1
175 Madison Ave Fl 2
Mount Holly, NJ 08060-2038
Phone (609) 914-6000
Other practice location 2
90 Brick Rd Fl 3
Marlton, NJ 08053-2177
Phone (856) 355-6000
Other practice location 3
100 Bowman Dr Lowr Level1
Voorhees, NJ 08043-9612
Phone (856) 247-3000
Other practice location 4
218 Sunset Rd Fl 5
Willingboro, NJ 08046-1110
Phone (609) 835-3056
Other practice location 5
1600 Haddon Ave Fl 6
Camden, NJ 08103-3101
Phone (856) 757-3500
Other names 1
- Marilyn Beatty
Electronic endpoints 5
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | mbeatty111758@directvirtua.org | ||
| Direct Messaging Address | mbeatty111758@directvirtua.org | ||
| Direct Messaging Address | mbeatty111758@directvirtua.org | ||
| Direct Messaging Address | mbeatty111758@directvirtua.org | ||
| Direct Messaging Address | mbeatty111758@directvirtua.org |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in PA, NJ
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 2
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- Other, 2015
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
1600 Haddon Ave
Camden, NJ 08103-3101
Phone (954) 939-5000
Hospital & facility affiliations
- Virtua Our Lady of Lourdes Hospital
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 25MP00371600 | NJ | MD | Physician Assistant |
| MA057625 | PA | MD | Medical Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Einstein Practice Plan Inc | Current | Accepting new patients | |
| Virtua Medical Group, PA | Current | Accepting new patients | |
| Virtua Medical Group, PA | Physician Assistant | Current | Accepting new patients |
| Einstein Practice Plan Inc | Current | Accepting new patients | |
| Einstein Practice Plan Inc | Past | Accepting new patients | |
| Virtua Medical Group, PA | Past | Accepting new patients |
Locations
3242 Route 206
Ste 2
Bordentown, NJ 08505
Phone (609) 298-4340
1600 Haddon Ave
Fl 6
Camden, NJ 08103
Phone (856) 247-2160
90 Brick Rd
Fl 3
Marlton, NJ 08053
Phone (856) 247-2160
175 Madison Ave
Fl 2
Mount Holly, NJ 08060
Phone (609) 914-6198
100 Bowman Dr
Lowr
Voorhees, NJ 08043
Phone (856) 247-3000
218 Sunset Rd
Fl 5
Willingboro, NJ 08046
Phone (609) 444-0359
5501 York Rd
Philadelphia, PA 19141
Phone (215) 456-7405
5501 Old York Rd
Ste 3
Philadelphia, PA 19141
Phone (215) 456-7180
5501 York Rd
Ste 202
Philadelphia, PA 19141
Phone (215) 254-2630
Organizations & group practices 8
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.
-
- Emergency Medicine Physician
- Camden, NJ
- NPI 1558312785
-
- Family Medicine Physician
- Marlton, NJ
- NPI 1649226515
-
- Psychiatry Physician
- Philadelphia, PA
- NPI 1760434468
-
- Certified Registered Nurse Anesthetist
- Philadelphia, PA
- NPI 1457047433
-
- Emergency Medicine Physician
- Philadelphia, PA
- NPI 1457304198
-
- Orthopaedic Surgery Physician
- Delran, NJ
- NPI 1841087988
Physician Assistant
-
- Foot & Ankle Surgery Podiatrist
- Marlton, NJ
- NPI 1902356215
-
- Internal Medicine Physician
- Philadelphia, PA
- NPI 1801853288
Hospital & facility affiliations 1
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Camden, NJ
- NPI 1235134024
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1434931200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1640217600000",
"number": "1174905657",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1616 COUNTY LINE RD",
"city": "CHALFONT",
"state": "PA",
"postal_code": "189141201",
"telephone_number": "215-589-0262"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5501 OLD YORK RD",
"city": "PHILADELPHIA",
"state": "PA",
"postal_code": "191413018",
"telephone_number": "215-456-6560"
}
],
"practiceLocations": [
{
"address_1": "175 Madison Ave Fl 2",
"address_purpose": "LOCATION",
"city": "Mount Holly",
"state": "NJ",
"postal_code": "080602038",
"country_code": "US",
"telephone_number": "609-914-6000",
"fax_number": "609-914-6182",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "90 Brick Rd Fl 3",
"address_purpose": "LOCATION",
"city": "Marlton",
"state": "NJ",
"postal_code": "080532177",
"country_code": "US",
"telephone_number": "856-355-6000",
"fax_number": "856-355-6731",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "100 Bowman Dr Lowr Level1",
"address_purpose": "LOCATION",
"city": "Voorhees",
"state": "NJ",
"postal_code": "080439612",
"country_code": "US",
"telephone_number": "856-247-3000",
"fax_number": "856-247-2597",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "218 Sunset Rd Fl 5",
"address_purpose": "LOCATION",
"city": "Willingboro",
"state": "NJ",
"postal_code": "080461110",
"country_code": "US",
"telephone_number": "609-835-3056",
"fax_number": "609-835-5741",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "1600 Haddon Ave Fl 6",
"address_purpose": "LOCATION",
"city": "Camden",
"state": "NJ",
"postal_code": "081033101",
"country_code": "US",
"telephone_number": "856-757-3500",
"fax_number": "856-365-4088",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "SPAGNOL",
"first_name": "MARILYN",
"middle_name": "IRENE",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2015-06-22",
"last_updated": "2021-12-23",
"certification_date": "2021-12-23",
"status": "A"
},
"taxonomies": [
{
"code": "363AM0700X",
"taxonomy_group": "",
"desc": "Physician Assistant, Medical",
"state": "PA",
"license": "MA057625",
"primary": false
},
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "NJ",
"license": "25MP00371600",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "mbeatty111758@directvirtua.org",
"affiliation": "N",
"address_1": "1600 Haddon Ave Fl 6",
"city": "Camden",
"state": "NJ",
"country_code": "US",
"postal_code": "081033101",
"country_name": "United States",
"address_type": "DOM"
},
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "mbeatty111758@directvirtua.org",
"affiliation": "N",
"address_1": "175 Madison Ave Fl 2",
"city": "Mount Holly",
"state": "NJ",
"country_code": "US",
"postal_code": "080602038",
"country_name": "United States",
"address_type": "DOM"
},
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "mbeatty111758@directvirtua.org",
"affiliation": "N",
"address_1": "100 Bowman Dr Lowr Level1",
"city": "Voorhees",
"state": "NJ",
"country_code": "US",
"postal_code": "080439612",
"country_name": "United States",
"address_type": "DOM"
},
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "mbeatty111758@directvirtua.org",
"affiliation": "N",
"address_1": "90 Brick Rd Fl 3",
"city": "Marlton",
"state": "NJ",
"country_code": "US",
"postal_code": "080532177",
"country_name": "United States",
"address_type": "DOM"
},
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "mbeatty111758@directvirtua.org",
"affiliation": "N",
"address_1": "218 Sunset Rd Fl 5",
"city": "Willingboro",
"state": "NJ",
"country_code": "US",
"postal_code": "080461110",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": [
{
"first_name": "MARILYN",
"last_name": "BEATTY",
"code": "1",
"type": "Former Name"
}
]
}
Other providers in Philadelphia, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 23, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.