Individual provider Active NPI

Lora Waldman, MD

  • Gynecology Physician
  • Mount Holly, NJ
National Provider Identifier
1255657318
Registry record updated Aug 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gynecology PhysicianTaxonomy code 207VG0400X
License
25MA12144900 Issued in NJ
Practice address
175 Madison Ave FL 3
Mount Holly, NJ 08060-2099
Phone
(609) 914-6198
NPI assigned
Apr 14, 2010
Last updated
Aug 30, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 30, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X MD451675 PA
Gynecology Physician 207VG0400X MD451675 PA
Gynecology Physician 207VG0400X 25MA12144900 NJ Primary

Addresses

Primary practice location

175 Madison Ave FL 3
Mount Holly, NJ 08060-2099

Mailing address

301 Lippincott Dr Ste 410
Marlton, NJ 08053-4197
Phone (856) 355-0340

Other practice location 1

100 E Lancaster Ave
Suite 433 MOB West
Wynnewood, PA 19096-3450
Phone (610) 896-8840

Electronic endpoints 3

TypeEndpointUseAffiliation
Direct Messaging Address lwaldman264896@directvirtua.org
Direct Messaging Address lwaldman264896@directvirtua.org
Direct Messaging Address lwaldman264896@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
I20240429003466 NJ Practitioner - Obstetrics/Gynecology 2365674025 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MD451675PAMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Virtua Medical Group, PA Gynecology Current Accepting new patients
Virtua Medical Group, PA CurrentSince Mar 24, 2024 Accepting new patients
Virtua Medical Group, PA CurrentSince Mar 24, 2024 Accepting new patients
Virtua - West Jersey Health System, Inc. Past Accepting new patients
Professional Anesthesia Services of North America P.C. Past Accepting new patients

Locations

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

1600 Haddon Ave
Fl 4
Camden, NJ 08103
Phone (856) 757-3500

301 Lippincott Dr
Ste 410
Marlton, NJ 08053

303 Lippincott Dr
Marlton, NJ 08053

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

175 Madison Ave
Fl 3
Mount Holly, NJ 08060
Phone (609) 914-6198

100 Bowman Dr
Fl 3
Voorhees, NJ 08043
Phone (856) 247-3000

Interoperability endpoints

  • Direct secure messaging: lwaldman264896@directvirtua.org

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1271203200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724976000000",
    "number": "1255657318",
    "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",
            "telephone_number": "856-355-0340"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "175 MADISON AVE FL 3",
            "city": "MOUNT HOLLY",
            "state": "NJ",
            "postal_code": "080602099",
            "telephone_number": "609-914-6198"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "100 E Lancaster Ave",
            "address_2": "Suite 433 MOB West",
            "address_purpose": "LOCATION",
            "city": "Wynnewood",
            "state": "PA",
            "postal_code": "190963450",
            "country_code": "US",
            "telephone_number": "610-896-8840",
            "fax_number": "610-642-5148",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WALDMAN",
        "first_name": "LORA",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-04-14",
        "last_updated": "2024-08-30",
        "certification_date": "2024-08-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "PA",
            "license": "MD451675",
            "primary": false
        },
        {
            "code": "207VG0400X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Gynecology",
            "state": "PA",
            "license": "MD451675",
            "primary": false
        },
        {
            "code": "207VG0400X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Gynecology",
            "state": "NJ",
            "license": "25MA12144900",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "lwaldman264896@directvirtua.org",
            "affiliation": "N",
            "address_1": "175 Madison Ave Fl 3",
            "city": "Mount Holly",
            "state": "NJ",
            "country_code": "US",
            "postal_code": "080602099",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "lwaldman264896@directvirtua.org",
            "affiliation": "N",
            "address_1": "100 Bowman Dr Fl 3",
            "city": "Voorhees",
            "state": "NJ",
            "country_code": "US",
            "postal_code": "080439612",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "lwaldman264896@directvirtua.org",
            "affiliation": "N",
            "address_1": "1600 Haddon Ave Fl 4",
            "city": "Camden",
            "state": "NJ",
            "country_code": "US",
            "postal_code": "081033101",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Mount Holly, NJ

Sources for this page

Verify at the official NPI Registry.