Individual provider Active NPI

Amanda Hetzel, NP

  • Acute Care Nurse Practitioner
  • Camden, NJ
National Provider Identifier
1366045403
Registry record updated Aug 21, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
26NJ01452800 Issued in NJ
Practice address
1 Cooper PLZ
Camden, NJ 08103-1461
Phone
(800) 826-6737
Fax
(856) 968-8279
NPI assigned
Nov 20, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 21, 2023

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 26NR20759000 NJ
Registered Nurse 163W00000X RN543986 PA
Acute Care Nurse Practitioner 363LA2100X SP026763 PA
Acute Care Nurse Practitioner 363LA2100X 26NJ01452800 NJ Primary

Addresses

Primary practice location

1 Cooper PLZ
Camden, NJ 08103-1461

Mailing address

1 Federal St Ste 200
Camden, NJ 08103-1088
Phone (848) 288-6935

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA, NJ2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20230313000029 PA Practitioner - Nurse Practitioner 7416321500 Reassigns benefits to 1 organization
I20230427003192 NJ Practitioner - Nurse Practitioner 7416321500 Reassigns benefits to 2 organizations

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
Cooper Surgical Associates, PAGroup PAC ID 3274430764, 303 clinicians

Practice addresses (Care Compare)

1 Cooper PLZ
Camden, NJ 08103-1461
Phone (856) 270-4100

Hospital & facility affiliations

  • Cooper University Hospital Hospital, Camden, NJ, CCN 310014

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
26NR20759000NJMDRegistered Nurse
RN543986PAMDRegistered Nurse
26NJ01452800NJMDAcute Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Trinity Health Mid-Atlantic Medical Group CurrentSince Mar 1, 2023 Accepting new patients
Capital Health Medical Group CurrentSince May 22, 2023 Accepting new patients
Cooper Surgical Associates, PA CurrentSince Jul 1, 2023 Accepting new patients
Trinity Health Mid-Atlantic Medical Group Current Accepting new patients
Trinity Health Mid-Atlantic Medical Group CurrentSince Mar 1, 2023 Accepting new patients
Cooper Surgical Associates, PA CurrentSince Jul 1, 2023 Accepting new patients
Trinity Health Mid-Atlantic Medical Group Past Accepting new patients

Locations

3 Cooper Plz
Rm 403
Camden, NJ 08103
Phone (856) 342-2439

3 Cooper Plz
Rm 411
Camden, NJ 08103
Phone (856) 342-2270

1 Cooper Plz
Camden, NJ 08103
Phone (856) 342-2425

3131 Princeton Pike
Bldg 5
Lawrenceville, NJ 08648
Phone (609) 844-9661

1 Capital Way
Pennington, NJ 08534
Phone (609) 303-4000

2 Capital Way
Ste 356
Pennington, NJ 08534
Phone (609) 537-6000

1203 Langhorne Newtown Rd
Ste 226
Langhorne, PA 19047
Phone (215) 710-4460

41 University Dr
Ste 300
Newtown, PA 18940
Phone (215) 710-7037

1201 Langhorne Newtown Rd
Penndel, PA 19047
Phone (215) 710-2100

Interoperability endpoints

  • Direct secure messaging: ahetzel104076@direct.cooperhealth.edu
  • FHIR API: https://api.platform.athenahealth.com/12833/brand/1/csg/1/fhir/r4

Organizations & group practices 7

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 2

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": "1605830400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692576000000",
    "number": "1366045403",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 FEDERAL ST STE 200",
            "city": "CAMDEN",
            "state": "NJ",
            "postal_code": "081031088",
            "telephone_number": "848-288-6935",
            "fax_number": "732-790-0107"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 COOPER PLZ",
            "city": "CAMDEN",
            "state": "NJ",
            "postal_code": "081031461",
            "telephone_number": "800-826-6737",
            "fax_number": "856-968-8279"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HETZEL",
        "first_name": "AMANDA",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-11-20",
        "last_updated": "2023-08-21",
        "certification_date": "2023-08-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NJ",
            "license": "26NR20759000",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "PA",
            "license": "RN543986",
            "primary": false
        },
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "PA",
            "license": "SP026763",
            "primary": false
        },
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "NJ",
            "license": "26NJ01452800",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Camden, NJ

Sources for this page

Verify at the official NPI Registry.