Timothy Joseph McSorley, ANP-BC
Individual provider Active NPI Adult Health Nurse Practitioner · Newfield, NJ
NPI 1205185485 · NPPES record last updated Mar 4, 2022
Key facts
- NPI
- 1205185485
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Adult Health Nurse Practitioner 363LA2200X
- License
- SP011365 (PA)
- Practice address
- 5260 Lake Road
Newfield, NJ 08344-5217 - Phone
- (856) 694-5437
- NPI assigned
- Sep 5, 2012
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NJ
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20130913000780 | NJ | Order and Referring Only - Nurse Practitioner | 9537303417 |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 26NJ00332700 | NJ | MD | Adult Health Nurse Practitioner |
| SP011365 | PA | MD | Adult Health Nurse Practitioner |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Adult Health Nurse Practitioner | 363LA2200X | 26NJ00332700 | NJ | |
| Adult Health Nurse Practitioner | 363LA2200X | SP011365 | PA | Yes |
Addresses
Primary practice location
5260 Lake Road
Newfield, NJ 08344-5217
Mailing address
5260 Lake Road
Newfield, NJ 08344-5217
Phone (856) 694-5437
Other providers in Newfield, NJ
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- Christine Hill
- Stephanie Marie Iglesias
- Maggie D McCool
- Mela Maxx LLC
- Daniela Moore
- Metajean Myerscough
- National Mentor Healthcare, LLC
- National Mentor Healthcare, LLC
All providers in Newfield, NJ · Adult Health Nurse Practitioner in New Jersey
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 4, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.