Individual provider Active NPI

Samantha Ann Smetaniuk, FNP

  • Family Nurse Practitioner
  • Moorestown, NJ
National Provider Identifier
1336852128
Registry record updated Jan 23, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
26NJ01307700 Issued in NJ
Practice address
401 Young Ave Ste 375a
Moorestown, NJ 08057-3130
Phone
(856) 291-8920
Fax
(856) 291-8922
NPI assigned
Dec 27, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 23, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 26NJ01307700 NJ Primary

Addresses

Primary practice location

401 Young Ave Ste 375a
Moorestown, NJ 08057-3130

Mailing address

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

Other practice location 1

200 Bowman Dr Ste E300
Voorhees, NJ 08043-9623
Phone (856) 247-7515

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address sfletcher103957@directvirtua.org
Direct Messaging Address sfletcher103957@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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230204000247 NJ Practitioner - Nurse Practitioner 5092187831 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Kennedy Medical Group Practice, P.C.Group PAC ID 2860616877, 417 clinicians

Practice addresses (Care Compare)

900 Medical Ctr Dr
Suite 201
Sewell, NJ 08080-2358
Phone (844) 542-2273

Hospital & facility affiliations

  • Jefferson Stratford Hospital Hospital, Stratford, NJ, CCN 310086

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

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Virtua Medical Group, PA CurrentSince Feb 5, 2023 Accepting new patients
Kennedy Medical Group Practice PC CurrentSince Feb 1, 2025 Accepting new patients
Virtua Medical Group, PA Current Accepting new patients
Kennedy Medical Group Practice, P.C. CurrentSince Feb 1, 2025 Accepting new patients
Kennedy Medical Group Practice P.C. Past Accepting new patients

Locations

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

2211 Chapel Ave W
Ste 301
Cherry Hill, NJ 08002
Phone (844) 309-7708

457 Haddonfield Rd
Ste 110
Cherry Hill, NJ 08002
Phone (856) 406-4091

15 E Redman Ave
Ste A
Haddonfield, NJ 08033
Phone (856) 428-1335

301 Lippincott Dr
Ste 410
Marlton, NJ 08053

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

401 Young Ave
Ste 375A
Moorestown, NJ 08057
Phone (856) 291-8920

400 Medical Center Dr
Ste F
Sewell, NJ 08080
Phone (856) 256-7705

900 Medical Center Dr
Ste 201
Sewell, NJ 08080
Phone (856) 218-2100

200 Bowman Dr
Ste E300
Voorhees, NJ 08043
Phone (856) 247-7515

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 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": "1672099200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1737590400000",
    "number": "1336852128",
    "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": "401 YOUNG AVE STE 375A",
            "city": "MOORESTOWN",
            "state": "NJ",
            "postal_code": "080573130",
            "telephone_number": "856-291-8920",
            "fax_number": "856-291-8922"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "200 Bowman Dr Ste E300",
            "address_purpose": "LOCATION",
            "city": "Voorhees",
            "state": "NJ",
            "postal_code": "080439623",
            "country_code": "US",
            "telephone_number": "856-247-7515",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SMETANIUK",
        "first_name": "SAMANTHA",
        "middle_name": "ANN",
        "name_prefix": "Mrs.",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-12-27",
        "last_updated": "2025-01-23",
        "certification_date": "2025-01-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NJ",
            "license": "26NJ01307700",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "sfletcher103957@directvirtua.org",
            "affiliation": "N",
            "address_1": "200 Bowman Dr Ste E300",
            "city": "Voorhees",
            "state": "NJ",
            "country_code": "US",
            "postal_code": "080439623",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "sfletcher103957@directvirtua.org",
            "affiliation": "N",
            "address_1": "401 Young Ave Ste 375A",
            "city": "Moorestown",
            "state": "NJ",
            "country_code": "US",
            "postal_code": "080573130",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Moorestown, NJ

Sources for this page

Verify at the official NPI Registry.