Stacy Ruderman, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

25MP00409500 Issued in NJ

Practice address

200 Bowman Dr
Suite 355
Voorhees, NJ 08043-9623

Phone

(856) 428-7700

Fax

(856) 247-7511

NPI assigned

Sep 1, 2016

Last updated

Oct 22, 2024By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

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

Specialty

Physician Assistant

Education

Other, 2016

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)

Hospital & facility affiliations

• West Jersey Hospital Hospital, Voorhees, NJ, CCN 310022

Merit-based Incentive Payment System (MIPS)

Final score

81.15 of 100Reported as group

Quality

62.28

Promoting interoperability

100

Improvement activities

40

Cost

74.89

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: sruderman18930@directvirtua.org

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.

• Virtua Medical Group, PA

  • Family Medicine Physician
  • Marlton, NJ
  • NPI 1649226515
  Medicare reassignment Care Compare group NPD (past)
• Virtua Medical Group, PA

  dba Virtua Reconstructive Orthopedics - Delran

  • Orthopaedic Surgery Physician
  • Delran, NJ
  • NPI 1841087988

  Physician Assistant

  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Virtua - West Jersey Health System, Inc.

  • General Acute Care Hospital
  • Voorhees, NJ
  • NPI 1528064409
  Care Compare affiliation

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1472688000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729555200000",
    "number": "1326595836",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7000 ATRIUM WAY",
            "city": "MOUNT LAUREL",
            "state": "NJ",
            "postal_code": "080543917",
            "telephone_number": "856-206-4508"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 BOWMAN DR",
            "address_2": "SUITE 355",
            "city": "VOORHEES",
            "state": "NJ",
            "postal_code": "080439623",
            "telephone_number": "856-428-7700",
            "fax_number": "856-247-7511"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUDERMAN",
        "first_name": "STACY",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-09-01",
        "last_updated": "2024-10-22",
        "certification_date": "2024-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NJ",
            "license": "25MP00409500",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "sruderman18930@directvirtua.org",
            "affiliation": "N",
            "address_1": "200 Bowman Dr",
            "address_2": "Suite 355",
            "city": "Voorhees",
            "state": "NJ",
            "country_code": "US",
            "postal_code": "080439623",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Matthew Royce, PTA
• Lawrence T Rozanski, M.D.
• Heather Ann Rozencwaig, APN
• Jenna Marie Rudd, CRNP
• Timothy Rudderow
• Katherine L Rudolph
• Alexus A Ruffin
• Daniel Rupert, C.R.N.A.
• Josephine Russ, DMD
• John J. Ryan, PA-C

• Physician Assistant in Voorhees, NJ
• Providers in Voorhees, NJ by specialty
• Physician Assistant in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 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; Order and Referring.
• 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.