NPIMap

Organization Active NPI

Samaritan Homevisit Physicians PC

  • Internal Medicine Physician
  • Mount Laurel, NJ
National Provider Identifier
1366088858
Registry record updated Oct 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
SAMARITAN HOMEVISIT PHYSICIANS PC
Practice address
3906 Church Rd
Mount Laurel, NJ 08054-1108
Phone
(856) 552-3261
NPI assigned
Nov 20, 2019
Last updated
Oct 29, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 29, 2024

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

Authorized official

Name
Rebecca Damato
Title
Director of Practice Management
Phone
(856) 596-1600

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X NU Primary

Addresses

Primary practice location

3906 Church Rd
Mount Laurel, NJ 08054-1108

Mailing address

3906 Church Rd
Mount Laurel, NJ 08054-1108
Phone (856) 596-1600

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20200115001513 NJ Part B Supplier - Clinic/Group Practice 8820423163 Receives reassigned benefits from 22 practitioners
Practice locations: Mount Laurel, NJ

National Provider Directory

National Provider Directory

Locations

1979 Route 70 E
Cherry Hill, NJ 08003
Phone (856) 424-7227

5 Eves Dr
Ste 303
Marlton, NJ 08053

895 Westfield Rd
#One
Moorestown, NJ 08057
Phone (856) 914-0444

3906 Church Rd
Ste 100
Mount Laurel, NJ 08054

3906 Church Rd
Ste 200
Mount Laurel, NJ 08054

480 Woodlane Rd
Westampton, NJ 08060
Phone (609) 877-0555

Practitioners & affiliated clinicians

Practitioners 38

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 38

NPI Registry JSON

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

{
    "created_epoch": "1574208000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1730160000000",
    "number": "1366088858",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3906 CHURCH RD",
            "city": "MOUNT LAUREL",
            "state": "NJ",
            "postal_code": "080541108",
            "telephone_number": "856-596-1600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3906 CHURCH RD",
            "city": "MOUNT LAUREL",
            "state": "NJ",
            "postal_code": "080541108",
            "telephone_number": "856-552-3261"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAMARITAN HOMEVISIT PHYSICIANS PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-11-20",
        "last_updated": "2024-10-29",
        "certification_date": "2024-10-29",
        "status": "A",
        "authorized_official_last_name": "DAMATO",
        "authorized_official_first_name": "REBECCA",
        "authorized_official_title_or_position": "DIRECTOR OF PRACTICE MANAGEMENT",
        "authorized_official_telephone_number": "856-596-1600"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mount Laurel, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 29, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.