NPIMap

Organization Active NPI

University Urogynecology Association, PC

  • Obstetrics & Gynecology Physician
  • Voorhees, NJ
National Provider Identifier
1255352423
Registry record updated Jul 28, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
Legal business name
UNIVERSITY UROGYNECOLOGY ASSOCIATION, PC
Practice address
6012 Main Street
Voorhees, NJ 08043-4659
Phone
(856) 325-6622
Fax
(856) 325-6652
NPI assigned
Jul 22, 2006
Last updated
Jul 28, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 28, 2016

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

Authorized official

Name
Anthony J. Mazzarelli, M.D.
Title
Chief Medical Office
Phone
(856) 968-7858

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X
Obstetrics & Gynecology Physician 207V00000X NJ Primary
Plastic and Reconstructive Surgery Physician 2086S0122X

Addresses

Primary practice location

6012 Main Street
Voorhees, NJ 08043-4659

Mailing address

1 Federal Street
SW-200
Camden, NJ 08103-1155
Phone (856) 356-4924

Other identifiers 1

IdentifierTypeStateIssuer
8200301MedicaidNJ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20041124000490 NJ Part B Supplier - Clinic/Group Practice 0749245116 Receives reassigned benefits from 14 practitioners
Practice locations: Pennsville, NJ; Voorhees, NJ; Sewell, NJ; Mount Laurel, NJ; Moorestown, NJ; Marmora, NJ; Hamilton, NJ; Cape May Court House, NJ…

National Provider Directory

National Provider Directory

Locations

314 E Main St
Ste 406
Newark, DE 19711
Phone (302) 738-0555

223 N Main St
Ste 103
Cape May Court House, NJ 08210
Phone (609) 463-2273

1230 Whthrs Mrcvl Rd
Trenton, NJ 08619
Phone (609) 581-1700

8000 Centennial Rd Ste L
Voorhees, NJ 08043

Practitioners & affiliated clinicians

Practitioners 127

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 127

NPI Registry JSON

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

{
    "created_epoch": "1153526400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1469664000000",
    "number": "1255352423",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 FEDERAL STREET",
            "address_2": "SW-200",
            "city": "CAMDEN",
            "state": "NJ",
            "postal_code": "081031155",
            "telephone_number": "856-356-4924",
            "fax_number": "856-382-6455"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6012 MAIN STREET",
            "city": "VOORHEES",
            "state": "NJ",
            "postal_code": "080434659",
            "telephone_number": "856-325-6622",
            "fax_number": "856-325-6652"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UNIVERSITY UROGYNECOLOGY ASSOCIATION, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-22",
        "last_updated": "2016-07-28",
        "status": "A",
        "authorized_official_last_name": "MAZZARELLI",
        "authorized_official_first_name": "ANTHONY",
        "authorized_official_middle_name": "J.",
        "authorized_official_title_or_position": "CHIEF MEDICAL OFFICE",
        "authorized_official_telephone_number": "856-968-7858",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "NJ",
            "license": null,
            "primary": true
        },
        {
            "code": "2086S0122X",
            "taxonomy_group": "",
            "desc": "Surgery, Plastic and Reconstructive Surgery",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8200301",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Voorhees, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 28, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.