Individual provider Active NPI

Amanda Rota

  • Certified Registered Nurse Anesthetist
  • Voorhees, NJ
National Provider Identifier
1316723216
Registry record updated Aug 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
26NR18949800 Issued in NJ
Practice address
100 Bowman Dr FL 2
Voorhees, NJ 08043-9612
Phone
(856) 988-6260
NPI assigned
Sep 6, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 26NR18949800 NJ
Certified Registered Nurse Anesthetist 367500000X 26NR18949800 NJ Primary

Addresses

Primary practice location

100 Bowman Dr FL 2
Voorhees, NJ 08043-9612

Mailing address

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

Other practice location 1

100 Bowman Dr
Voorhees, NJ 08043-9612
Phone (856) 516-5399

Other practice location 2

200 Bowman Dr Ste D160
Voorhees, NJ 08043-9633
Phone (856) 988-6260

Other practice location 3

90 Brick Rd
Marlton, NJ 08053-2177
Phone (856) 988-6260

Electronic endpoints 3

TypeEndpointUseAffiliation
Direct Messaging Address arota263394@directvirtua.org
Direct Messaging Address arota263394@directvirtua.org
Direct Messaging Address arota263394@directvirtua.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240221003938 NJ Practitioner - Certified Registered Nurse Anesthetist (Crna) 0547604167 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Virtua Medical Group, PAGroup PAC ID 9830222397, 1,678 clinicians

Practice addresses (Care Compare)

100 Bowman Dr
Voorhees, NJ 08043-9612
Phone (856) 247-7260

3242 Route 206
Bordentown, NJ 08505-4517

90 Brick Rd
Marlton, NJ 08053-2177
Phone (856) 247-7260

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
26NR18949800NJMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Virtua Medical Group, PA CurrentSince Feb 24, 2024 Accepting new patients
Virtua Medical Group, PA CurrentSince Feb 24, 2024 Accepting new patients
Virtua Medical Group, PA Nurse Anesthetist, Certified Registered CurrentSince Mar 3, 2024 Accepting new patients

Locations

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

90 Brick Rd
Marlton, NJ 08053
Phone (856) 355-6040

301 Lippincott Dr
Ste 410
Marlton, NJ 08053

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

100 Bowman Dr
Fl 2
Voorhees, NJ 08043
Phone (856) 247-3000

200 Bowman Dr
Ste D160
Voorhees, NJ 08043
Phone (856) 247-7800

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

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 1

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": "1693958400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724284800000",
    "number": "1316723216",
    "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": "100 BOWMAN DR FL 2",
            "city": "VOORHEES",
            "state": "NJ",
            "postal_code": "080439612",
            "telephone_number": "856-988-6260"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "100 Bowman Dr",
            "address_purpose": "LOCATION",
            "city": "Voorhees",
            "state": "NJ",
            "postal_code": "080439612",
            "country_code": "US",
            "telephone_number": "856-516-5399",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "200 Bowman Dr Ste D160",
            "address_purpose": "LOCATION",
            "city": "Voorhees",
            "state": "NJ",
            "postal_code": "080439633",
            "country_code": "US",
            "telephone_number": "856-988-6260",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "90 Brick Rd",
            "address_purpose": "LOCATION",
            "city": "Marlton",
            "state": "NJ",
            "postal_code": "080532177",
            "country_code": "US",
            "telephone_number": "856-988-6260",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ROTA",
        "first_name": "AMANDA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-09-06",
        "last_updated": "2024-08-22",
        "certification_date": "2024-08-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NJ",
            "license": "26NR18949800",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "NJ",
            "license": "26NR18949800",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "arota263394@directvirtua.org",
            "affiliation": "N",
            "address_1": "100 Bowman Dr Fl 2",
            "city": "Voorhees",
            "state": "NJ",
            "country_code": "US",
            "postal_code": "080439612",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "arota263394@directvirtua.org",
            "affiliation": "N",
            "address_1": "90 Brick Rd",
            "city": "Marlton",
            "state": "NJ",
            "country_code": "US",
            "postal_code": "080532177",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "arota263394@directvirtua.org",
            "affiliation": "N",
            "address_1": "200 Bowman Dr Ste D160",
            "city": "Voorhees",
            "state": "NJ",
            "country_code": "US",
            "postal_code": "080439633",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Voorhees, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.