Individual provider Active NPI

Wanda I Coss, MD

  • Pediatrics Physician
  • Medford, NJ
National Provider Identifier
1326025404
Registry record updated Jan 16, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
25MA06285700 Issued in NJ
Practice address
520 Stokes Rd
Ironstone Building B10
Medford, NJ 08055-2904
Phone
(609) 654-9112
Fax
(609) 654-7404
NPI assigned
Dec 29, 2005
Last updated
Jan 16, 2013By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 16, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 25MA06285700 NJ Primary

Addresses

Primary practice location

520 Stokes Rd
Ironstone Building B10
Medford, NJ 08055-2904

Mailing address

402 Lippincott Dr
Marlton, NJ 08053-4112
Phone (856) 782-3300

Other identifiers 1

IdentifierTypeStateIssuer
6695809MedicaidNJ

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
I20041028000019 NJ Practitioner - Pediatric Medicine 2961464466 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Advocare, LLC Pediatrics CurrentSince Aug 1, 2023 Accepting new patients
Advocare , LLC CurrentSince Aug 1, 2023 Accepting new patients
Lourdes Medical Associates PA Pediatrics Past Accepting new patients
Advocare, LLC Pediatrics Past Accepting new patients
Advocare, LLC Pediatrics Past Accepting new patients

Locations

132 Grove St
Ste A
Haddonfield, NJ 08033
Phone (856) 354-2211

401 Route 73 N
Ste 320
Marlton, NJ 08053
Phone (609) 471-1033

402 Lippincott Dr
Marlton, NJ 08053
Phone (410) 763-8787

520 Stokes Rd
Ste B10
Medford, NJ 08055
Phone (609) 654-9112

Interoperability endpoints

  • Direct secure messaging: wanda.coss@advocaredoctors.eclinicaldirectplus.com

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": "1135814400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1358294400000",
    "number": "1326025404",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "402 LIPPINCOTT DR",
            "city": "MARLTON",
            "state": "NJ",
            "postal_code": "080534112",
            "telephone_number": "856-782-3300",
            "fax_number": "856-504-8029"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "520 STOKES RD",
            "address_2": "IRONSTONE BUILDING B10",
            "city": "MEDFORD",
            "state": "NJ",
            "postal_code": "080552904",
            "telephone_number": "609-654-9112",
            "fax_number": "609-654-7404"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COSS",
        "first_name": "WANDA",
        "middle_name": "I",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-12-29",
        "last_updated": "2013-01-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NJ",
            "license": "25MA06285700",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6695809",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Medford, NJ

Sources for this page

Verify at the official NPI Registry.