Individual provider Active NPI

Ryan Omalley, RN, MSN, AGACNP

  • Acute Care Nurse Practitioner
  • Voorhees, NJ
National Provider Identifier
1376903435
Registry record updated Oct 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
26NJ00646800 Issued in NJ
Practice address
200 Bowman Dr
Suite 355
Voorhees, NJ 08043-9623
Phone
(865) 247-7210
NPI assigned
Mar 2, 2016
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 30, 2024

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 26NJ00646800 NJ Primary

Addresses

Primary practice location

200 Bowman Dr
Suite 355
Voorhees, NJ 08043-9623

Mailing address

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

Other identifiers 1

IdentifierTypeStateIssuer
0547841MedicaidNJ

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address romalley19817@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
I20161019000116 NJ Practitioner - Nurse Practitioner 0042508343 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
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)

100 Bowman Dr
Voorhees, NJ 08043-9612
Phone (856) 247-7260

3242 Route 206
Bordentown, NJ 08505-4517

90 Brick Rd
Marlton, NJ 08053-2177
Phone (856) 247-7260

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

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science - Nursing, Nurse Practitioner, Registered Nurse

State licenses

LicenseStateTypeSpecialty
26NJ00646800NJMDAcute Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Virtua Medical Group, PA CurrentSince Oct 1, 2016 Accepting new patients
Virtua Medical Group, PA CurrentSince Oct 1, 2016 Accepting new patients
Cooper University Trauma Physicians, PC CurrentSince Dec 24, 2016 Accepting new patients

Locations

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

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

301 Lippincott Dr
Ste 410
Marlton, NJ 08053

200 Bowman Dr
Ste 355
Voorhees, NJ 08043
Phone (856) 274-7210

Interoperability endpoints

  • Direct secure messaging: romalley19817@directvirtua.org

Organizations & group practices 3

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": "1456876800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730246400000",
    "number": "1376903435",
    "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": "200 BOWMAN DR",
            "address_2": "SUITE 355",
            "city": "VOORHEES",
            "state": "NJ",
            "postal_code": "080439623",
            "telephone_number": "865-247-7210"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OMALLEY",
        "first_name": "RYAN",
        "name_prefix": "Mr.",
        "credential": "RN, MSN, AGACNP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-03-02",
        "last_updated": "2024-10-30",
        "certification_date": "2024-10-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "NJ",
            "license": "26NJ00646800",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0547841",
            "state": "NJ"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "romalley19817@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": []
}

Other providers in Voorhees, NJ

Sources for this page

Verify at the official NPI Registry.