Individual provider Active NPI

Elisa Conway, APN

  • Family Nurse Practitioner
  • Linwood, NJ
National Provider Identifier
1275950230
Registry record updated Jun 29, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
26NJ00505100 Issued in NJ
Practice address
2106 New Rd Ste D4
Linwood, NJ 08221-1050
Phone
(609) 926-6474
Fax
(609) 926-6474
NPI assigned
Mar 27, 2014
Last updated
Jun 29, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 29, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 26NJ00505100 NJ Primary

Addresses

Primary practice location

2106 New Rd Ste D4
Linwood, NJ 08221-1050

Mailing address

2099 New Albany Rd
Cinnaminson, NJ 08077-3534
Phone (609) 926-8899

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140911000067 NJ Practitioner - Nurse Practitioner 1456570142 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Coyle S Connolly DO PAGroup PAC ID 2961498118, 32 clinicians
Clark Dermatology LLCGroup PAC ID 5395703573, 46 clinicians

Practice addresses (Care Compare)

2099 New Albany Rd
Cinnaminson, NJ 08077-3534
Phone 60992688991196

3071 E Chestnut Ave
D12 Metropolitan Dermatology
Vineland, NJ 08361-7847
Phone (856) 691-1737

Merit-based Incentive Payment System (MIPS)

Final score
93.23 of 100Reported as group
Quality
95.33
Promoting interoperability
86
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Coyle S Connolly DO PA CurrentSince Oct 31, 2016 Accepting new patients

Locations

2099 New Albany Rd
Cinnaminson, NJ 08077
Phone (856) 829-5545

392 N White Horse Pike
Ste 3
Hammonton, NJ 08037

2106 New Rd
Ste D4
Linwood, NJ 08221
Phone (609) 926-6474

151 Fries Mill Rd
Ste 405
Turnersville, NJ 08012
Phone (609) 387-2030

1667 E Landis Ave
Bldg C
Vineland, NJ 08361
Phone (800) 732-2940

Organizations & group practices 2

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": "1395878400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687996800000",
    "number": "1275950230",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2099 NEW ALBANY RD",
            "city": "CINNAMINSON",
            "state": "NJ",
            "postal_code": "080773534",
            "telephone_number": "609-926-8899",
            "fax_number": "856-772-1997"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2106 NEW RD STE D4",
            "city": "LINWOOD",
            "state": "NJ",
            "postal_code": "082211050",
            "telephone_number": "609-926-6474",
            "fax_number": "609-926-6474"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CONWAY",
        "first_name": "ELISA",
        "credential": "APN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-03-27",
        "last_updated": "2023-06-29",
        "certification_date": "2023-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NJ",
            "license": "26NJ00505100",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Linwood, NJ

Sources for this page

Verify at the official NPI Registry.