Organization Active NPI

Radiology Associates of Burlington County P a

  • Diagnostic Radiology Physician
  • Mount Holly, NJ
National Provider Identifier
1255385183
Registry record updated May 28, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
Legal business name
RADIOLOGY ASSOCIATES OF BURLINGTON COUNTY P A
Practice address
175 Madison Ave
Mount Holly, NJ 08060-2038
Phone
(609) 267-0700
NPI assigned
May 22, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 28, 2025

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

Authorized official

Name
Tiffany Fogle
Title
Manager of Credentialing
Phone
(919) 763-1112

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2085R0202X Primary

Addresses

Primary practice location

175 Madison Ave
Mount Holly, NJ 08060-2038

Mailing address

400 Fellowship Rd Ste 200
Mount Laurel, NJ 08054-3437

Other identifiers 1

IdentifierTypeStateIssuer
2700107MedicaidNJ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ, MI, CO, TX, FL, OR, NY, WA, CT, NV, MO, KY, AZ, MA, KS, IA, HI, SD, ME, NH, AL, NE, WI, PA, DC, TN, GA, VA, NC, IN, CA, LA, MS, IL, AK, UT, GU, MT, PR39 enrollments

Enrollment records 39

Enrollment IDStateProvider typePAC IDDetails
O20050408000763 NJ Part B Supplier - Clinic/Group Practice 7012954381 Receives reassigned benefits from 88 practitioners
Practice locations: Basking Ridge, NJ; Denville, NJ; Livingston, NJ; Margate City, NJ; Moorestown, NJ; Mount Holly, NJ; New Vernon, NJ
O20240813001628 MI Part B Supplier - Clinic/Group Practice 7012954381 Receives reassigned benefits from 4 practitioners
Practice locations: Brighton, MI; Canton, MI; Grosse Pointe Shores, MI; Ypsilanti, MI
O20250523000743 CO Part B Supplier - Clinic/Group Practice 7012954381 Receives reassigned benefits from 8 practitioners
Practice locations: Avon, CO; Carbondale, CO; Castle Pines, CO; Castle Rock, CO; Crested Butte, CO; Denver, CO; Fort Collins, CO; Steamboat Springs, CO
O20250527001223 TX Part B Supplier - Clinic/Group Practice 7012954381 Receives reassigned benefits from 9 practitioners
Practice locations: Tyler, TX; Sugar Land, TX; North Richland Hills, TX; Frisco, TX; Edinburg, TX; Dallas, TX; Carrollton, TX; Leander, TX
O20250527001303 FL Part B Supplier - Clinic/Group Practice 7012954381 Receives reassigned benefits from 13 practitioners
Practice locations: Jacksonville, FL; Winter Springs, FL; Sarasota, FL; Saint Petersburg, FL; Port Saint Lucie, FL; Palm Harbor, FL; Milton, FL; Lakewood Ranch, FL…
O20250528002618 OR Part B Supplier - Clinic/Group Practice 7012954381 Receives reassigned benefits from 3 practitioners
Practice locations: Bend, OR; Eugene, OR; Portland, OR
O20250602000057 NY Part B Supplier - Clinic/Group Practice 7012954381 Receives reassigned benefits from 8 practitioners
Practice locations: Poughkeepsie, NY; West Point, NY; New York, NY; East Hampton, NY
O20250602000842 WA Part B Supplier - Clinic/Group Practice 7012954381 Receives reassigned benefits from 4 practitioners
Practice locations: Arlington, WA; Gold Bar, WA; Woodinville, WA; Yarrow Point, WA
O20250603001444 CT Part B Supplier - Clinic/Group Practice 7012954381 Receives reassigned benefits from 4 practitioners
Practice locations: Farmington, CT; Greenwich, CT; West Hartford, CT; Woodbridge, CT
O20250604003741 NV Part B Supplier - Clinic/Group Practice 7012954381 Receives reassigned benefits from 4 practitioners
Practice locations: Henderson, NV; Las Vegas, NV
O20250606001205 MO Part B Supplier - Clinic/Group Practice 7012954381 Receives reassigned benefits from 3 practitioners
Practice locations: Joplin, MO; Rolla, MO; Saint Louis, MO
O20250612001803 KY Part B Supplier - Clinic/Group Practice 7012954381 Receives reassigned benefits from 2 practitioners
Practice locations: Lexington, KY; Louisville, KY
O20250613000744 AZ Part B Supplier - Clinic/Group Practice 7012954381 Receives reassigned benefits from 5 practitioners
Practice locations: Flagstaff, AZ; Paradise Valley, AZ; Scottsdale, AZ; Tucson, AZ
O20250617001228 MA Part B Supplier - Clinic/Group Practice 7012954381 Receives reassigned benefits from 1 practitioner
Practice locations: Alford, MA
O20250617002168 KS Part B Supplier - Clinic/Group Practice 7012954381 Receives reassigned benefits from 1 practitioner
Practice locations: Prairie Village, KS
O20250617002729 IA Part B Supplier - Clinic/Group Practice 7012954381 Receives reassigned benefits from 3 practitioners
Practice locations: Iowa City, IA; Cedar Falls, IA; Burlington, IA
O20250617003923 HI Part B Supplier - Clinic/Group Practice 7012954381 Receives reassigned benefits from 1 practitioner
Practice locations: Honolulu, HI
O20250618002997 SD Part B Supplier - Clinic/Group Practice 7012954381 Receives reassigned benefits from 1 practitioner
Practice locations: Spearfish, SD
O20250619000892 ME Part B Supplier - Clinic/Group Practice 7012954381 Receives reassigned benefits from 1 practitioner
Practice locations: Stockton Springs, ME
O20250619001173 NH Part B Supplier - Clinic/Group Practice 7012954381 Receives reassigned benefits from 1 practitioner
Practice locations: Raymond, NH
O20250619001507 AL Part B Supplier - Clinic/Group Practice 7012954381 Receives reassigned benefits from 1 practitioner
Practice locations: Madison, AL
O20250620002490 NE Part B Supplier - Clinic/Group Practice 7012954381 Receives reassigned benefits from 1 practitioner
Practice locations: Bellevue, NE
O20250623001888 WI Part B Supplier - Clinic/Group Practice 7012954381 Receives reassigned benefits from 1 practitioner
Practice locations: Fitchburg, WI
O20250627002408 PA Part B Supplier - Clinic/Group Practice 7012954381 Receives reassigned benefits from 5 practitioners
Practice locations: Danville, PA; Philadelphia, PA; Newtown Square, PA; Easton, PA; Maple Glen, PA
O20250628000399 DC Part B Supplier - Clinic/Group Practice 7012954381 Receives reassigned benefits from 2 practitioners
Practice locations: Kensington, MD; MC Lean, VA
O20250630002844 TN Part B Supplier - Clinic/Group Practice 7012954381 Receives reassigned benefits from 4 practitioners
Practice locations: Memphis, TN; Murfreesboro, TN; Nashville, TN; Rockwood, TN
O20250707001043 GA Part B Supplier - Clinic/Group Practice 7012954381 Receives reassigned benefits from 2 practitioners
Practice locations: Moultrie, GA; Peachtree City, GA
O20250707002517 VA Part B Supplier - Clinic/Group Practice 7012954381 Receives reassigned benefits from 4 practitioners
Practice locations: Crozier, VA; Henrico, VA; Midlothian, VA; Virginia Beach, VA
O20250707004013 NC Part B Supplier - Clinic/Group Practice 7012954381 Receives reassigned benefits from 4 practitioners
Practice locations: Chapel Hill, NC; Hillsborough, NC
O20250710000414 IN Part B Supplier - Clinic/Group Practice 7012954381 Receives reassigned benefits from 1 practitioner
Practice locations: Hanover, IN
O20250812003697 CA Part B Supplier - Clinic/Group Practice 7012954381 Receives reassigned benefits from 22 practitioners
Practice locations: Murrieta, CA; Newark, CA; Newport Coast, CA; Oceanside, CA; Rancho Mirage, CA; Redlands, CA; Sacramento, CA; San Diego, CA…
O20250825000150 LA Part B Supplier - Clinic/Group Practice 7012954381 Receives reassigned benefits from 1 practitioner
Practice locations: Belle Chasse, LA
O20250825000286 MS Part B Supplier - Clinic/Group Practice 7012954381 Receives reassigned benefits from 1 practitioner
Practice locations: Jackson, MS
O20250905001400 IL Part B Supplier - Clinic/Group Practice 7012954381 Receives reassigned benefits from 4 practitioners
Practice locations: Chicago, IL; Oak Brook, IL; Lincolnshire, IL; Naperville, IL
O20250908002131 AK Part B Supplier - Clinic/Group Practice 7012954381 Receives reassigned benefits from 2 practitioners
Practice locations: Homer, AK
O20250908002900 UT Part B Supplier - Clinic/Group Practice 7012954381 Receives reassigned benefits from 1 practitioner
Practice locations: Woods Cross, UT
O20250908004027 GU Part B Supplier - Clinic/Group Practice 7012954381 Receives reassigned benefits from 1 practitioner
Practice locations: Tamuning, GU
O20250908004156 MT Part B Supplier - Clinic/Group Practice 7012954381 Receives reassigned benefits from 1 practitioner
Practice locations: Eureka, MT
O20260414004105 PR Part B Supplier - Clinic/Group Practice 7012954381 Receives reassigned benefits from 1 practitioner
Practice locations: Carolina, PR

National Provider Directory

National Provider Directory

Locations

1295 Route 38
Hainesport, NJ 08036
Phone (609) 261-7017

2986 Box
Philadelphia, PA 19178

Practitioners & affiliated clinicians

Practitioners 228

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 228

NPI Registry JSON

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

{
    "created_epoch": "1148256000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1748390400000",
    "number": "1255385183",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 FELLOWSHIP RD STE 200",
            "city": "MOUNT LAUREL",
            "state": "NJ",
            "postal_code": "080543437"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "175 MADISON AVE",
            "city": "MOUNT HOLLY",
            "state": "NJ",
            "postal_code": "080602038",
            "telephone_number": "609-267-0700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RADIOLOGY ASSOCIATES OF BURLINGTON COUNTY P A",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-22",
        "last_updated": "2025-05-28",
        "certification_date": "2025-05-28",
        "status": "A",
        "authorized_official_last_name": "FOGLE",
        "authorized_official_first_name": "TIFFANY",
        "authorized_official_title_or_position": "MANAGER OF CREDENTIALING",
        "authorized_official_telephone_number": "919-763-1112"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Radiology, Diagnostic Radiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2700107",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mount Holly, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 28, 2025; 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.