Individual provider Active NPI

Alexandra Desimone

  • Family Medicine Physician
  • Marlton, NJ
National Provider Identifier
1306228143
Registry record updated Mar 17, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
25MA10348700 Issued in NJ
Practice address
141 Route 70 E Ste E
Marlton, NJ 08053-1855
Phone
(856) 985-7373
Fax
(856) 985-9611
NPI assigned
Jun 28, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Family Medicine Physician 207Q00000X 25MA10348700 NJ Primary

Addresses

Primary practice location

141 Route 70 E Ste E
Marlton, NJ 08053-1855

Mailing address

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

Other practice location 1

425 1st St
Brooklyn, NY 11215-2507
Phone (518) 932-9323

Other names 1

  • Alexandra Mineo Former name

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address adesimone74169@directvirtua.org
Direct Messaging Address adesimone74169@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
I20181213000544 NJ Practitioner - Family Practice 8729323167 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Virtua Medical Group, PAGroup PAC ID 9830222397, 1,678 clinicians

Practice addresses (Care Compare)

141 Route 70 E
Marlton, NJ 08053-1855

3242 Route 206
Bordentown, NJ 08505-4517

Hospital & facility affiliations

  • Virtua Home Care at West Jersey Home health agency, Marlton, NJ, CCN 317071
  • Samaritan Healthcare and Hospice Hospice, Mount Laurel, NJ, CCN 311504
  • West Jersey Hospital Hospital, Voorhees, NJ, CCN 310022
  • Virtua Mount Holly Hospital Hospital, Mount Holly, NJ, CCN 310057
  • Virtua Our Lady of Lourdes Hospital Hospital, Camden, NJ, CCN 310029

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Virtua Medical Group, PA CurrentSince Dec 1, 2018 Accepting new patients
Virtua Medical Group, PA Family Medicine Current Accepting new patients
Virtua Medical Group, PA CurrentSince Dec 1, 2018 Accepting new patients

Locations

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

141 Route 70 E
Ste E
Marlton, NJ 08053
Phone (856) 985-7373

303 Lippincott Dr
Marlton, NJ 08053

301 Lippincott Dr
Ste 120
Marlton, NJ 08053
Phone (856) 355-0333

301 Lippincott Dr
Ste 410
Marlton, NJ 08053

239 Hurffville Crosskeys Rd
Ste 350A
Sewell, NJ 08080
Phone (856) 589-0300

Interoperability endpoints

  • Direct secure messaging: adesimone74169@directvirtua.org

Organizations & group practices 3

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.

Hospital & facility affiliations 5

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": "1435449600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1647475200000",
    "number": "1306228143",
    "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",
            "fax_number": "856-355-0330"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "141 ROUTE 70 E STE E",
            "city": "MARLTON",
            "state": "NJ",
            "postal_code": "080531855",
            "telephone_number": "856-985-7373",
            "fax_number": "856-985-9611"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "425 1st St",
            "address_purpose": "LOCATION",
            "city": "Brooklyn",
            "state": "NY",
            "postal_code": "112152507",
            "country_code": "US",
            "telephone_number": "518-932-9323",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DESIMONE",
        "first_name": "ALEXANDRA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-06-28",
        "last_updated": "2022-03-17",
        "certification_date": "2022-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NJ",
            "license": "25MA10348700",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "adesimone74169@directvirtua.org",
            "affiliation": "N",
            "address_1": "239 Hurffville Crosskeys Rd Ste 350A",
            "city": "Sewell",
            "state": "NJ",
            "country_code": "US",
            "postal_code": "080804007",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "adesimone74169@directvirtua.org",
            "affiliation": "N",
            "address_1": "141 Route 70 E Ste E",
            "city": "Marlton",
            "state": "NJ",
            "country_code": "US",
            "postal_code": "080531855",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "ALEXANDRA",
            "last_name": "MINEO",
            "credential": "M.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Marlton, NJ

Sources for this page

Verify at the official NPI Registry.