Individual provider Active NPI

Conrado Manalo Sampedro, APN

  • Acute Care Nurse Practitioner
  • Pomona, NJ
National Provider Identifier
1356118699
Registry record updated Dec 6, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
26NJ14936900 Issued in NJ
Practice address
65 W Jimmie Leeds Rd
Pomona, NJ 08240-9102
Phone
(609) 652-1000
NPI assigned
Dec 6, 2023
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 6, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X 26NJ14936900 NJ Primary

Addresses

Primary practice location

65 W Jimmie Leeds Rd
Pomona, NJ 08240-9102

Mailing address

114 Scenic LN
Mays Landing, NJ 08330-4935
Phone (551) 358-3600

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
I20240314001595 NJ Practitioner - Nurse Practitioner 7012353824 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Atlanticare Physician Group PAGroup PAC ID 8527953660, 506 clinicians

Practice addresses (Care Compare)

2500 English Creek Ave
Suite 211
Egg Harbor Township, NJ 08234-5598
Phone (609) 677-7776

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
26NJ14936900NJMDAcute Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Atlanticare Physician Group CurrentSince Jan 30, 2024 Accepting new patients
Atlanticare Physician Group, PA CurrentSince Jan 30, 2024 Accepting new patients
Atlanticare Regional Medical Center CurrentSince Aug 15, 2025 Accepting new patients
Atlanticare Regional Medical Center Acute Care CurrentSince Aug 15, 2025 Accepting new patients
Atlanticare Physician Group PA Current Accepting new patients

Locations

1925 Pacific Ave
Atlantic City, NJ 08401
Phone (609) 441-8023

2500 English Creek Ave
Ste 211
Egg Harbor Twp, NJ 08234
Phone (609) 677-6000

459 Route 9 S
Little Egg Harbor Twp, NJ 08087
Phone (609) 340-7815

3600 State Route 66
Fl 3
Neptune City, NJ 07753
Phone (732) 807-0463

65 W Jimmie Leeds Rd
Pomona, NJ 08240
Phone (609) 484-6414

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": "1701820800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701820800000",
    "number": "1356118699",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "114 SCENIC LN",
            "city": "MAYS LANDING",
            "state": "NJ",
            "postal_code": "083304935",
            "telephone_number": "551-358-3600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "65 W JIMMIE LEEDS RD",
            "city": "POMONA",
            "state": "NJ",
            "postal_code": "082409102",
            "telephone_number": "609-652-1000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SAMPEDRO",
        "first_name": "CONRADO",
        "middle_name": "MANALO",
        "credential": "APN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-12-06",
        "last_updated": "2023-12-06",
        "certification_date": "2023-12-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "NJ",
            "license": "26NJ14936900",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pomona, NJ

Sources for this page

Verify at the official NPI Registry.