Individual provider Active NPI

Marina Yani

  • Nurse Practitioner
  • Medford, NJ
National Provider Identifier
1184447070
Registry record updated Nov 7, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
26NJ15203500 Issued in NJ
Practice address
103 Old Marlton Pike Ste 124
Medford, NJ 08055-8772
Phone
(888) 575-9162
NPI assigned
Nov 7, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 7, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 26NJ15203500 NJ Primary

Addresses

Primary practice location

103 Old Marlton Pike Ste 124
Medford, NJ 08055-8772

Mailing address

83 Whitford Dr
Burlington, NJ 08016-4359
Phone (609) 251-2445

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
I20241230000916 NJ Practitioner - Nurse Practitioner 4880121037 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

4390 Route 130
Suite a
Willingboro, NJ 08046-1065
Phone (267) 781-7315

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
26NJ15203500NJMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Life Choice Hospice of New Jersey, LLC CurrentSince Jan 31, 2025 Accepting new patients
Omega Physicians LLC CurrentSince Nov 1, 2024 Accepting new patients
Life Choice Hospice of New Jersey, LLC Past Accepting new patients

Locations

510 Liberty St
Camden, NJ 08104
Phone (856) 541-6092

76 W Jimmie Leeds Rd
Ste A
Galloway, NJ 08205
Phone (856) 387-0500

103 Old Marlton Pike
Ste 124
Medford, NJ 08055
Phone (856) 387-0500

4390 Route 130
Ste A
Willingboro, NJ 08046
Phone (267) 781-7315

10 Cadillac Dr
Ste 400
Brentwood, TN 37027
Phone (615) 637-9163

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, 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": "1730937600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730937600000",
    "number": "1184447070",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "83 WHITFORD DR",
            "city": "BURLINGTON",
            "state": "NJ",
            "postal_code": "080164359",
            "telephone_number": "609-251-2445"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "103 OLD MARLTON PIKE STE 124",
            "city": "MEDFORD",
            "state": "NJ",
            "postal_code": "080558772",
            "telephone_number": "888-575-9162"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YANI",
        "first_name": "MARINA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-11-07",
        "last_updated": "2024-11-07",
        "certification_date": "2024-11-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NJ",
            "license": "26NJ15203500",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Medford, NJ

Sources for this page

Verify at the official NPI Registry.