Individual provider Active NPI

Tara Ricciardi, NP

  • Family Nurse Practitioner
  • Sewell, NJ
National Provider Identifier
1386257632
Registry record updated Aug 26, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
26NJ01026800 Issued in NJ
Practice address
378 Fries Mill Rd
Sewell, NJ 08080-9203
Phone
(856) 218-4200
NPI assigned
Aug 26, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 26, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 26NJ01026800 NJ Primary

Addresses

Primary practice location

378 Fries Mill Rd
Sewell, NJ 08080-9203

Mailing address

333 N Summit St FL 15
Toledo, OH 43604-2615
Phone (419) 252-6031

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
I20200831001027 NJ Practitioner - Nurse Practitioner 3375960727 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Regional Womens Health Group LLCGroup PAC ID 2961316328, 352 clinicians

Practice addresses (Care Compare)

247 Hurffville Crosskeys Rd
Sewell, NJ 08080-4011
Phone (856) 840-8017

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
26NJ01026800NJMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Regional Women's Health Group, LLC CurrentSince May 24, 2024 Accepting new patients
Regional Womens Health Group LLC CurrentSince May 24, 2024 Accepting new patients

Locations

399 Front St
Unit E
Elmer, NJ 08318
Phone (856) 223-8930

34 Colson Ln
Mullica Hill, NJ 08062
Phone (856) 223-0500

247 Hurffville Crosskeys Rd
Ste 3-C
Sewell, NJ 08080
Phone (856) 840-8017

188 Fries Mill Rd
Ste N1
Turnersville, NJ 08012
Phone (609) 261-7023

227 Laurel Rd
Ste 300
Voorhees, NJ 08043
Phone (856) 669-6025

603 N Broad St
Ste 300
Woodbury, NJ 08096
Phone (856) 223-8930

40 Village Green Dr
Woolwich Twp, NJ 08085
Phone (856) 223-8930

Interoperability endpoints

  • Direct secure messaging: tara.ricciardi@axia.eclinicaldirectplus.com

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1598400000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1598400000000",
    "number": "1386257632",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "333 N SUMMIT ST FL 15",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436042615",
            "telephone_number": "419-252-6031",
            "fax_number": "800-564-5952"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "378 FRIES MILL RD",
            "city": "SEWELL",
            "state": "NJ",
            "postal_code": "080809203",
            "telephone_number": "856-218-4200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RICCIARDI",
        "first_name": "TARA",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-08-26",
        "last_updated": "2020-08-26",
        "certification_date": "2020-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NJ",
            "license": "26NJ01026800",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sewell, NJ

Sources for this page

Verify at the official NPI Registry.