Individual provider Active NPI

Pamela Anne Marie Fazio, DO

  • Nuclear Cardiology Physician
  • Moorestown, NJ
National Provider Identifier
1235623810
Registry record updated Sep 4, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nuclear Cardiology PhysicianTaxonomy code 207UN0901X
License
25MB11110400 Issued in NJ
Practice address
728 Marne Hwy Ste 200a
Moorestown, NJ 08057-3128
Phone
(856) 291-8855
NPI assigned
Jun 18, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 4, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 25MB11110400 NJ
Student in an Organized Health Care Education/Training Program 390200000X OT018437 PA
Nuclear Cardiology Physician 207UN0901X 25MB11110400 NJ Primary

Addresses

Primary practice location

728 Marne Hwy Ste 200a
Moorestown, NJ 08057-3128

Mailing address

301 Lippincott Dr Ste 410
Marlton, NJ 08053-4197

Other practice location 1

10800 Knights Rd
Philadelphia, PA 19114-4200
Phone (215) 612-5161

Other practice location 2

6500 K Johnson Blvd Ste 100C
Bordentown, NJ 08505-2282
Phone (609) 759-9660

Other practice location 3

128 Route 70 Ste 1B
Medford, NJ 08055-2371
Phone (856) 291-8855

Other practice location 4

1 Sheffield Dr Ste 201
Columbus, NJ 08022-9506
Phone (856) 291-8855

Electronic endpoints 4

TypeEndpointUseAffiliation
Direct Messaging Address pfazio275286@directvirtua.org
Direct Messaging Address pfazio275286@directvirtua.org
Direct Messaging Address pfazio275286@directvirtua.org
Direct Messaging Address pfazio275286@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
I20240810000063 NJ Practitioner - Cardiovascular Disease (Cardiology) 8325396682 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Virtua Medical Group, PAGroup PAC ID 9830222397, 1,678 clinicians

Practice addresses (Care Compare)

1 Brace Rd
Cherry Hill, NJ 08034-2600

1 Sheffield Dr
Suite 201
Columbus, NJ 08022-9506
Phone (609) 291-8855

128 Route 70
Medford, NJ 08055-2371

175 Madison Ave
Mount Holly, NJ 08060-2038

2 Sindoni LN
Hammonton, NJ 08037-1884

2309 E Evesham Rd
Voorhees, NJ 08043-1559

3242 Route 206
Bordentown, NJ 08505-4517

728 Marne Hwy
Moorestown, NJ 08057-3128

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

State licenses

LicenseStateTypeSpecialty
25MB11110400NJMDNuclear Cardiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Virtua Medical Group, PA CurrentSince Aug 19, 2024 Accepting new patients
Virtua Medical Group, PA CurrentSince Aug 19, 2024 Accepting new patients
Virtua Medical Group, PA Internal Medicine CurrentSince Sep 8, 2024 Accepting new patients

Locations

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

1 Sheffield Dr
Ste 201
Columbus, NJ 08022
Phone (609) 291-8855

303 Lippincott Dr
Marlton, NJ 08053

301 Lippincott Dr
Ste 410
Marlton, NJ 08053

303 Lippincott Dr
Ste 200
Marlton, NJ 08053
Phone (856) 355-0335

128 Route 70
Ste 1B
Medford, NJ 08055
Phone (856) 206-4786

728 Marne Hwy
Ste 200A
Moorestown, NJ 08057
Phone (856) 291-8855

Interoperability endpoints

  • Direct secure messaging: pfazio275286@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 and National Provider Directory roles.

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": "1529280000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1725408000000",
    "number": "1235623810",
    "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"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "728 MARNE HWY STE 200A",
            "city": "MOORESTOWN",
            "state": "NJ",
            "postal_code": "080573128",
            "telephone_number": "856-291-8855"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "10800 Knights Rd",
            "address_purpose": "LOCATION",
            "city": "Philadelphia",
            "state": "PA",
            "postal_code": "191144200",
            "country_code": "US",
            "telephone_number": "215-612-5161",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "6500 K Johnson Blvd Ste 100C",
            "address_purpose": "LOCATION",
            "city": "Bordentown",
            "state": "NJ",
            "postal_code": "085052282",
            "country_code": "US",
            "telephone_number": "609-759-9660",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "128 Route 70 Ste 1B",
            "address_purpose": "LOCATION",
            "city": "Medford",
            "state": "NJ",
            "postal_code": "080552371",
            "country_code": "US",
            "telephone_number": "856-291-8855",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1 Sheffield Dr Ste 201",
            "address_purpose": "LOCATION",
            "city": "Columbus",
            "state": "NJ",
            "postal_code": "080229506",
            "country_code": "US",
            "telephone_number": "856-291-8855",
            "fax_number": "609-444-5526",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FAZIO",
        "first_name": "PAMELA",
        "middle_name": "ANNE MARIE",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-06-18",
        "last_updated": "2024-09-04",
        "certification_date": "2024-09-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NJ",
            "license": "25MB11110400",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "PA",
            "license": "OT018437",
            "primary": false
        },
        {
            "code": "207UN0901X",
            "taxonomy_group": "",
            "desc": "Nuclear Medicine, Nuclear Cardiology",
            "state": "NJ",
            "license": "25MB11110400",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "pfazio275286@directvirtua.org",
            "affiliation": "N",
            "address_1": "728 Marne Hwy Ste 200A",
            "city": "Moorestown",
            "state": "NJ",
            "country_code": "US",
            "postal_code": "080573128",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "pfazio275286@directvirtua.org",
            "affiliation": "N",
            "address_1": "1 Sheffield Dr Ste 201",
            "city": "Columbus",
            "state": "NJ",
            "country_code": "US",
            "postal_code": "080229506",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "pfazio275286@directvirtua.org",
            "affiliation": "N",
            "address_1": "128 Route 70 Ste 1B",
            "city": "Medford",
            "state": "NJ",
            "country_code": "US",
            "postal_code": "080552371",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "pfazio275286@directvirtua.org",
            "affiliation": "N",
            "address_1": "6500 K Johnson Blvd Ste 100C",
            "city": "Bordentown",
            "state": "NJ",
            "country_code": "US",
            "postal_code": "085052282",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Moorestown, NJ

Sources for this page

Verify at the official NPI Registry.