Individual provider Active NPI

Alexis Udalovas, APN

  • Psychiatric/Mental Health Nurse Practitioner
  • Marlton, NJ
National Provider Identifier
1386081651
Registry record updated Sep 19, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
26NJ00454600 Issued in NJ
Practice address
765 E Route 70
Building a
Marlton, NJ 08053-2341
Phone
(856) 983-3900
NPI assigned
May 28, 2013
Last updated
Sep 19, 2013By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 19, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 26NJ00454600 NJ Primary

Addresses

Primary practice location

765 E Route 70
Building a
Marlton, NJ 08053-2341

Mailing address

765 E Route 70
Building a
Marlton, NJ 08053-2341
Phone (856) 983-3900

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
I20140311001714 NJ Practitioner - Nurse Practitioner 9133359201 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Center for Family Guidance PCGroup PAC ID 2860396454, 164 clinicians

Practice addresses (Care Compare)

100 Bowman Dr
Voorhees, NJ 08043-9612
Phone (856) 247-3000

155 Bridgeton Pike
Mullica Hill, NJ 08062-2638
Phone (856) 223-0500

175 Madison Ave
FL 6
Mount Holly, NJ 08060-2038
Phone (609) 261-3200

218 A Sunset Rd
Willingboro, NJ 08046-1110
Phone (609) 835-2900

333 Irving Ave
Bridgeton, NJ 08302-2123
Phone (609) 451-6600

425 Woodbury Turnersville Rd
Blackwood, NJ 08012-2960
Phone (856) 374-6600

90 Brick Rd
Marlton, NJ 08053-2177
Phone (856) 355-6000

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
26NJ00454600NJMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Center for Family Guidance, PC Psychiatric/Mental Health CurrentSince Nov 9, 2013 Accepting new patients

Locations

333 Irving Ave
Bridgeton, NJ 08302
Phone (856) 575-4500

765 Route 70 E
Bldg A
Marlton, NJ 08053
Phone (856) 797-4721

Interoperability endpoints

  • Direct secure messaging: alexis.udalovas.p1@direct.cfg.nextgenshare.com
  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 4

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": "1369699200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1379548800000",
    "number": "1386081651",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "765 E ROUTE 70",
            "address_2": "BUILDING A",
            "city": "MARLTON",
            "state": "NJ",
            "postal_code": "080532341",
            "telephone_number": "856-983-3900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "765 E ROUTE 70",
            "address_2": "BUILDING A",
            "city": "MARLTON",
            "state": "NJ",
            "postal_code": "080532341",
            "telephone_number": "856-983-3900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "UDALOVAS",
        "first_name": "ALEXIS",
        "credential": "APN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-05-28",
        "last_updated": "2013-09-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NJ",
            "license": "26NJ00454600",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Marlton, NJ

Sources for this page

Verify at the official NPI Registry.