Melody Jan Boudwin, P.A.

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

25MP00226700 Issued in NJ

Practice address

8001 Route 130
Delran, NJ 08075-1870

Phone

(856) 461-1400

Fax

(856) 461-2366

NPI assigned

Dec 29, 2009

Last updated

Mar 30, 2016By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

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.

• Dermone Dermatology Associates of the Garden State, PC

  • MOHS-Micrographic Surgery Physician
  • Freehold, NJ
  • NPI 1053771048
  NPD (past)

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

{
    "created_epoch": "1262044800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1459296000000",
    "number": "1235469149",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "33 BROOK DR",
            "city": "BURLINGTON",
            "state": "NJ",
            "postal_code": "080163932",
            "telephone_number": "856-461-1400",
            "fax_number": "856-461-2366"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8001 ROUTE 130",
            "city": "DELRAN",
            "state": "NJ",
            "postal_code": "080751870",
            "telephone_number": "856-461-1400",
            "fax_number": "856-461-2366"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOUDWIN",
        "first_name": "MELODY",
        "middle_name": "JAN",
        "name_prefix": "Miss",
        "credential": "P.A.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-12-29",
        "last_updated": "2016-03-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NJ",
            "license": "25MP00226700",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Pascale Bastien, M.D.
• Sara Battaglia, LSW
• Renee A Berna, MD
• Julie Black, WHNP-BC
• Dylan Marie Bobek, OTR/L
• Brighter Dental Care (Delran)
• C & S LLC (Talk of the Town Speech and Language Center)
• Lauren Cackowski
• Alex Cadwallader, DPT
• Denese Campbell

• Physician Assistant in Delran, NJ
• Providers in Delran, NJ by specialty
• Physician Assistant in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 30, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.