Individual provider Active NPI

Julie Ninja Polisiakiewicz, D.O.

  • Pulmonary Disease Physician
  • Cherry Hill, NJ
National Provider Identifier
1184918351
Registry record updated May 27, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pulmonary Disease PhysicianTaxonomy code 207RP1001X
License
25MB10454900 Issued in NJ
Practice address
107 Berlin Rd
Cherry Hill, NJ 08034-3526
Phone
(856) 429-1800
Fax
(856) 429-1081
NPI assigned
Jun 6, 2011
Last updated
May 27, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 27, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X NU
Pulmonary Disease Physician 207RP1001X 25MB10454900 NJ Primary

Addresses

Primary practice location

107 Berlin Rd
Cherry Hill, NJ 08034-3526

Mailing address

301 Lippincott Dr Ste 410
Marlton, NJ 08053-4197
Phone (856) 355-0340

Other practice location 1

3 Saint Elizabeth Blvd Ste 5000
O Fallon, IL 62269-1282
Phone (618) 641-5803

Other practice location 2

750 Route 73, Building 4, Suite 401
Marlton, NJ 08053
Phone (856) 375-1288

Other practice location 3

1113 Hospital Dr Ste 202A
Willingboro, NJ 08046-1129
Phone (856) 375-1288

Other identifiers 1

IdentifierTypeStateIssuer
0665631MedicaidNJ

Electronic endpoints 3

TypeEndpointUseAffiliation
Direct Messaging Address jpolisiakiewicz91392@directvirtua.org
Direct Messaging Address jpolisiakiewicz91392@directvirtua.org
Direct Messaging Address jpolisiakiewicz91392@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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190128000701 NJ Practitioner - Pulmonary DiseasePractitioner - Critical Care (Intensivists) 0042438335 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pulmonary DiseaseAlso: Critical Care (Intensivists)
Education
Other, 2011
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)

Marlton, NJ 08053
Phone (856) 355-0340

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

141 Route 70 E
Marlton, NJ 08053-1855

1600 Haddon Ave
Camden, NJ 08103-3101

175 Madison Ave
Mount Holly, NJ 08060-2038

218 Sunset Rd
FL 5
Willingboro, NJ 08046-1110
Phone (609) 444-0359

3242 Route 206
Bordentown, NJ 08505-4517

750 Route 73 S
Suite 401
Marlton, NJ 08053-4145
Phone (856) 375-1288

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
Doctor of Osteopathy

Practice roles

OrganizationSpecialtyStatusNew patients
Virtua Medical Group, PA CurrentSince Nov 1, 2020 Accepting new patients
Virtua Medical Group, PA Current Accepting new patients
Virtua Medical Group, PA CurrentSince Nov 1, 2020 Accepting new patients

Locations

3242 Route 206
Ste 2
Bordentown, NJ 08505
Phone (609) 298-4340

107 Berlin Rd
Cherry Hill, NJ 08034
Phone (856) 429-1800

301 Lippincott Dr
Ste 410
Marlton, NJ 08053

750 Route 73 S
Ste 401
Marlton, NJ 08053
Phone (856) 332-0767

1113 Hospital Dr
Ste 202A
Willingboro, NJ 08046
Phone (856) 375-1288

Interoperability endpoints

  • Direct secure messaging: jpolisiakiewicz91392@directvirtua.org

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.

Hospital & facility affiliations 4

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": "1307318400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1748304000000",
    "number": "1184918351",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "301 LIPPINCOTT DR STE 410",
            "city": "MARLTON",
            "state": "NJ",
            "postal_code": "080534197",
            "telephone_number": "856-355-0340",
            "fax_number": "856-355-0330"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "107 BERLIN RD",
            "city": "CHERRY HILL",
            "state": "NJ",
            "postal_code": "080343526",
            "telephone_number": "856-429-1800",
            "fax_number": "856-429-1081"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3 Saint Elizabeth Blvd Ste 5000",
            "address_purpose": "LOCATION",
            "city": "O Fallon",
            "state": "IL",
            "postal_code": "622691282",
            "country_code": "US",
            "telephone_number": "618-641-5803",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "750 Route 73, Building 4, Suite 401",
            "address_purpose": "LOCATION",
            "city": "Marlton",
            "state": "NJ",
            "postal_code": "08053",
            "country_code": "US",
            "telephone_number": "856-375-1288",
            "fax_number": "856-375-2325",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1113 Hospital Dr Ste 202A",
            "address_purpose": "LOCATION",
            "city": "Willingboro",
            "state": "NJ",
            "postal_code": "080461129",
            "country_code": "US",
            "telephone_number": "856-375-1288",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "POLISIAKIEWICZ",
        "first_name": "JULIE",
        "middle_name": "NINJA",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-06-06",
        "last_updated": "2025-05-27",
        "certification_date": "2025-05-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "NJ",
            "license": "25MB10454900",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0665631",
            "state": "NJ"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jpolisiakiewicz91392@directvirtua.org",
            "affiliation": "N",
            "address_1": "107 Berlin Rd",
            "city": "Cherry Hill",
            "state": "NJ",
            "country_code": "US",
            "postal_code": "080343526",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jpolisiakiewicz91392@directvirtua.org",
            "affiliation": "N",
            "address_1": "750 Route 73 S Bldg 4",
            "city": "Marlton",
            "state": "NJ",
            "country_code": "US",
            "postal_code": "080534141",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jpolisiakiewicz91392@directvirtua.org",
            "affiliation": "N",
            "address_1": "1113 Hospital Dr Ste 202A",
            "city": "Willingboro",
            "state": "NJ",
            "country_code": "US",
            "postal_code": "080461129",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Cherry Hill, NJ

Sources for this page

Verify at the official NPI Registry.