Individual provider Active NPI

Charles Joseph Elsea, AGPCNP-BC

  • Gerontology Nurse Practitioner
  • Camden, NJ
National Provider Identifier
1215501176
Registry record updated Dec 20, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Nurse PractitionerTaxonomy code 363LG0600X
License
26NJ01123500 Issued in NJ
Practice address
2 Cooper PLZ
Camden, NJ 08103-1461
Phone
(856) 342-2380
NPI assigned
May 16, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 20, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gerontology Nurse Practitioner 363LG0600X 26NJ01123500 NJ Primary

Addresses

Primary practice location

2 Cooper PLZ
Camden, NJ 08103-1461

Mailing address

1 Federal St Ste 200
Camden, NJ 08103-1088
Phone (848) 288-6935

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address elseac@go.stockton.edu

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
I20210623000650 NJ Practitioner - Nurse Practitioner 9335540731 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Cooper University Radiology PCGroup PAC ID 6305838764, 68 clinicians

Practice addresses (Care Compare)

400 Haddon Ave
Collingswood, NJ 08108-1330
Phone (855) 632-2667

Hospital & facility affiliations

  • Cooper University Hospital Hospital, Camden, NJ, CCN 310014
  • Cape Regional Medical Center Inc Hospital, Cape May Court House, NJ, CCN 310011

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Advocare, LLC CurrentSince Jun 15, 2021 Accepting new patients
Advocare , LLC CurrentSince Jun 15, 2021 Accepting new patients
Cooper University Radiology, PC CurrentSince Sep 1, 2022 Accepting new patients

Locations

527 S Black Horse Pike
Blackwood, NJ 08012
Phone (856) 228-1061

2 Cooper Plz
Camden, NJ 08103
Phone (609) 342-7600

1 Cooper Plz
Camden, NJ 08103
Phone (856) 342-2425

2 Cooper Plz
#400
Camden, NJ 08103
Phone (856) 342-2300

132 Grove St
Ste A
Haddonfield, NJ 08033
Phone (856) 354-2211

Interoperability endpoints

  • Direct secure messaging: celsea69701@direct.cooperhealth.edu

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 and National Provider Directory roles.

Hospital & facility affiliations 3

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": "1621123200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1703030400000",
    "number": "1215501176",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 FEDERAL ST STE 200",
            "city": "CAMDEN",
            "state": "NJ",
            "postal_code": "081031088",
            "telephone_number": "848-288-6935"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 COOPER PLZ",
            "city": "CAMDEN",
            "state": "NJ",
            "postal_code": "081031461",
            "telephone_number": "856-342-2380"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELSEA",
        "first_name": "CHARLES",
        "middle_name": "JOSEPH",
        "name_prefix": "Mr.",
        "credential": "AGPCNP-BC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-05-16",
        "last_updated": "2023-12-20",
        "certification_date": "2023-12-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "NJ",
            "license": "26NJ01123500",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "elseac@go.stockton.edu",
            "affiliation": "N",
            "address_1": "527 S Black Horse Pike",
            "city": "Blackwood",
            "state": "NJ",
            "country_code": "US",
            "postal_code": "080122868",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Camden, NJ

Sources for this page

Verify at the official NPI Registry.