NPIMap

Individual provider Active NPI

Lori A Depersia, M.D.

  • Diagnostic Radiology Physician
  • Meadowbrook, PA
National Provider Identifier
1295727352
Registry record updated Jun 18, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
MD029084E Issued in PA
Practice address
1648 Huntingdon Pike
Radiology Department
Meadowbrook, PA 19046-8001
Phone
(215) 938-3467
Fax
(215) 938-3474
NPI assigned
Aug 16, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 18, 2012

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X MD029084E PA Primary
Neuroradiology Physician 2085N0700X MD029084E PA

Addresses

Primary practice location

1648 Huntingdon Pike
Radiology Department
Meadowbrook, PA 19046-8001

Mailing address

1001 Briggs Rd
Suite 210
Mount Laurel, NJ 08054-4100
Phone (856) 231-4774

Other identifiers 3

IdentifierTypeStateIssuer
0073256900006MedicaidPA
007325269MedicaidPA
2210703MedicaidNJ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050103000818 NJ Practitioner - Diagnostic Radiology 4789579707 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Jefferson Medical College of Thomas Jefferson University, 1981
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Regional Diagnostic Imaging LLC 27 clinicians
Atlantic Medical Imaging 109 clinicians

Practice addresses (Care Compare)

1505 W Sherman Ave
Vineland, NJ 08360-7059
Phone (856) 641-7940

44 E Jimmie Leeds Rd
Suite 101
Galloway, NJ 08205-9599
Phone (609) 677-9729

Hospital & facility affiliations

  • Inspira Medical Center Mullica Hill Hospital, Elmer, NJ, CCN 310069
  • Inspira Medical Center Vineland Hospital, Vineland, NJ, CCN 310032

Merit-based Incentive Payment System (MIPS)

Final score
92.6 of 100Reported as group
Quality
98.86
Improvement activities
40
Cost
77.42

Merit-based Incentive Payment System (MIPS)

Final score
89.04 of 100Reported as group
Quality
84.62
Improvement activities
40
Cost
76.68

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD029084EPAMDNeuroradiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Regional Diagnostic Imaging, LLC Diagnostic Radiology CurrentSince Jan 1, 2016 Accepting new patients
Ami Atlanticare LLC CurrentSince Apr 1, 2023 Accepting new patients
Atlantic Medical Imaging CurrentSince Apr 1, 2023 Accepting new patients
Diagnostic Imaging Centers of Nepa, LLC Diagnostic Radiology Past Accepting new patients
Northeast Imaging Associates of Philadelphia, P.C. Neuroradiology Past Accepting new patients
Trinity Imaging Associates, P.C. Neuroradiology Past Accepting new patients
Coastalspine Radiology Diagnostic Radiology Past Accepting new patients
Imaging Associates, PA Past Accepting new patients
Bucks County Radiology Associates, PC Neuroradiology Past Accepting new patients
Stand-Up MRI of Cherry Hill Inc. Neuroradiology Past Accepting new patients
Heights Imaging Associates, PA Neuroradiology Past Accepting new patients
Life Care Medical Center Past Accepting new patients
University Open MRI PC Past Accepting new patients
Imaging Professionals of Pennsylvania PC Diagnostic Radiology Past Accepting new patients

Locations

44 E Jimmie Leeds Rd
Ste 101
Galloway, NJ 08205
Phone (609) 652-7349

219 N White Horse Pike
Hammonton, NJ 08037
Phone (609) 878-9729

1505 W Sherman Ave
Vineland, NJ 08360
Phone (856) 451-6600

Organizations & group practices 14

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.

View all 14

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": "1124150400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1339977600000",
    "number": "1295727352",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1001 BRIGGS RD",
            "address_2": "SUITE 210",
            "city": "MOUNT LAUREL",
            "state": "NJ",
            "postal_code": "080544100",
            "telephone_number": "856-231-4774",
            "fax_number": "856-231-9699"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1648 HUNTINGDON PIKE",
            "address_2": "RADIOLOGY DEPARTMENT",
            "city": "MEADOWBROOK",
            "state": "PA",
            "postal_code": "190468001",
            "telephone_number": "215-938-3467",
            "fax_number": "215-938-3474"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEPERSIA",
        "first_name": "LORI",
        "middle_name": "A",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-08-16",
        "last_updated": "2012-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "PA",
            "license": "MD029084E",
            "primary": true
        },
        {
            "code": "2085N0700X",
            "taxonomy_group": "",
            "desc": "Radiology, Neuroradiology",
            "state": "PA",
            "license": "MD029084E",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0073256900006",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "007325269",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2210703",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Meadowbrook, PA

Sources for this page

Verify at the official NPI Registry.