Individual provider Active NPI

Alexandra M Mazzarese

  • Physician Assistant
  • Marlton, NJ
National Provider Identifier
1174988745
Registry record updated Oct 10, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
25MP00440600 Issued in NJ
Practice address
90 Brick Rd FL 3
Marlton, NJ 08053-2177
Phone
(856) 355-6000
NPI assigned
Dec 23, 2015
Last updated
Oct 10, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 10, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 25MP00440600 NJ Primary
Student in an Organized Health Care Education/Training Program 390200000X NU

Addresses

Primary practice location

90 Brick Rd FL 3
Marlton, NJ 08053-2177

Mailing address

241 S 49TH St Apt 321
Philadelphia, PA 19139-4285
Phone (908) 432-2434

Other practice location 1

100 Bowman Dr Lowr Level2
Voorhees, NJ 08043-9612
Phone (856) 988-3444

Other practice location 2

1001 Route 73 N Uppr Level A
Marlton, NJ 08053-4524
Phone (856) 988-4444

Other practice location 3

218 Sunset Rd Fl 5
Willingboro, NJ 08046-1110
Phone (609) 835-2900

Other practice location 4

239 Hurffville Crosskeys Rd Ste 480A
Sewell, NJ 08080-4002
Phone (856) 988-3444

Electronic endpoints 5

TypeEndpointUseAffiliation
Direct Messaging Address amazzarese13847@directvirtua.org
Direct Messaging Address amazzarese13847@directvirtua.org
Direct Messaging Address amazzarese13847@directvirtua.org
Direct Messaging Address amazzarese13847@directvirtua.org
Direct Messaging Address amazzarese13847@directvirtua.org

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
I20171103000226 NJ Practitioner - Physician Assistant 2365708542 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Virtua Medical Group, PAGroup PAC ID 9830222397, 1,678 clinicians

Practice addresses (Care Compare)

100 Bowman Dr
Voorhees, NJ 08043-9612
Phone (856) 247-7260

3242 Route 206
Bordentown, NJ 08505-4517

90 Brick Rd
Marlton, NJ 08053-2177
Phone (856) 247-7260

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
81.15 of 100Reported as group
Quality
62.28
Promoting interoperability
100
Improvement activities
40
Cost
74.89

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
25MP00440600NJMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Virtua Medical Group, PA Physician Assistant CurrentSince Sep 6, 2017 Accepting new patients
Virtua Medical Group, PA CurrentSince Sep 6, 2017 Accepting new patients
Virtua Surgical Group, P.a 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

1001 Route 73 N
Uppr
Marlton, NJ 08053
Phone (856) 355-7137

90 Brick Rd
Fl 3
Marlton, NJ 08053
Phone (856) 247-2160

239 Hurffville Crosskeys Rd
Ste 480A
Sewell, NJ 08080

100 Bowman Dr
Lowr
Voorhees, NJ 08043
Phone (856) 247-2160

218 Sunset Rd
Fl 5
Willingboro, NJ 08046
Phone (609) 444-0359

Interoperability endpoints

  • Direct secure messaging: amazzarese13847@directvirtua.org

Organizations & group practices 4

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1450828800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728518400000",
    "number": "1174988745",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "241 S 49TH ST APT 321",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191394285",
            "telephone_number": "908-432-2434"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "90 BRICK RD FL 3",
            "city": "MARLTON",
            "state": "NJ",
            "postal_code": "080532177",
            "telephone_number": "856-355-6000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "100 Bowman Dr Lowr Level2",
            "address_purpose": "LOCATION",
            "city": "Voorhees",
            "state": "NJ",
            "postal_code": "080439612",
            "country_code": "US",
            "telephone_number": "856-988-3444",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1001 Route 73 N Uppr Level A",
            "address_purpose": "LOCATION",
            "city": "Marlton",
            "state": "NJ",
            "postal_code": "080534524",
            "country_code": "US",
            "telephone_number": "856-988-4444",
            "fax_number": "856-988-0553",
            "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": "609-835-2900",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "239 Hurffville Crosskeys Rd Ste 480A",
            "address_purpose": "LOCATION",
            "city": "Sewell",
            "state": "NJ",
            "postal_code": "080804002",
            "country_code": "US",
            "telephone_number": "856-988-3444",
            "fax_number": "856-988-0553",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MAZZARESE",
        "first_name": "ALEXANDRA",
        "middle_name": "M",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-12-23",
        "last_updated": "2024-10-10",
        "certification_date": "2024-10-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NJ",
            "license": "25MP00440600",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "amazzarese13847@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": "amazzarese13847@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"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "amazzarese13847@directvirtua.org",
            "affiliation": "N",
            "address_1": "1001 Route 73 N Uppr Level A",
            "city": "Marlton",
            "state": "NJ",
            "country_code": "US",
            "postal_code": "080534524",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "amazzarese13847@directvirtua.org",
            "affiliation": "N",
            "address_1": "239 Hurffville Crosskeys Rd Ste 480A",
            "city": "Sewell",
            "state": "NJ",
            "country_code": "US",
            "postal_code": "080804002",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "amazzarese13847@directvirtua.org",
            "affiliation": "N",
            "address_1": "100 Bowman Dr Lowr Level2",
            "city": "Voorhees",
            "state": "NJ",
            "country_code": "US",
            "postal_code": "080439612",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Marlton, NJ

Sources for this page

Verify at the official NPI Registry.