Individual provider Active NPI

Nicholas James Demosthenes

  • Anesthesiology Physician
  • Voorhees, NJ
National Provider Identifier
1386263697
Registry record updated Sep 4, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
25MA12120200 Issued in NJ
Practice address
100 Bowman Dr FL 2
Voorhees, NJ 08043-9612
Phone
(856) 988-6260
NPI assigned
Apr 16, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 4, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Anesthesiology Physician 207L00000X 25MA12120200 NJ Primary

Addresses

Primary practice location

100 Bowman Dr FL 2
Voorhees, NJ 08043-9612

Mailing address

301 Lippincott Dr Ste 410
Marlton, NJ 08053-4197
Phone (563) 550-3408

Other practice location 1

3400 Spruce St
Philadelphia, PA 19104-4238
Phone (215) 316-5151

Other practice location 2

200 Bowman Dr Ste D160
Voorhees, NJ 08043-9633
Phone (856) 988-6260

Other practice location 3

90 Brick Rd Fl Ground
Marlton, NJ 08053-2177
Phone (856) 988-6260

Electronic endpoints 3

TypeEndpointUseAffiliation
Direct Messaging Address ndemosthenes272227@directvirtua.org
Direct Messaging Address ndemosthenes272227@directvirtua.org
Direct Messaging Address ndemosthenes272227@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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240802000203 NJ Practitioner - Anesthesiology 2365985108 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
Other, 2020
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) 988-3444

Hospital & facility affiliations

  • West Jersey Hospital Hospital, Voorhees, NJ, CCN 310022

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Virtua Medical Group, PA CurrentSince Aug 1, 2024 Accepting new patients
Virtua Medical Group, PA CurrentSince Aug 1, 2024 Accepting new patients
Virtua Medical Group, PA Anesthesiology CurrentSince Jul 7, 2024 Accepting new patients

Locations

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

90 Brick Rd
Marlton, NJ 08053
Phone (856) 355-6040

301 Lippincott Dr
Ste 410
Marlton, NJ 08053

303 Lippincott Dr
Ste 200
Marlton, NJ 08053
Phone (856) 355-0335

200 Bowman Dr
Ste D160
Voorhees, NJ 08043
Phone (856) 247-7800

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

100 Bowman Dr
Fl 2
Voorhees, NJ 08043
Phone (856) 247-3000

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": "1586995200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1725408000000",
    "number": "1386263697",
    "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": "563-550-3408"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 BOWMAN DR FL 2",
            "city": "VOORHEES",
            "state": "NJ",
            "postal_code": "080439612",
            "telephone_number": "856-988-6260"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3400 Spruce St",
            "address_purpose": "LOCATION",
            "city": "Philadelphia",
            "state": "PA",
            "postal_code": "191044238",
            "country_code": "US",
            "telephone_number": "215-316-5151",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "200 Bowman Dr Ste D160",
            "address_purpose": "LOCATION",
            "city": "Voorhees",
            "state": "NJ",
            "postal_code": "080439633",
            "country_code": "US",
            "telephone_number": "856-988-6260",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "90 Brick Rd Fl Ground",
            "address_purpose": "LOCATION",
            "city": "Marlton",
            "state": "NJ",
            "postal_code": "080532177",
            "country_code": "US",
            "telephone_number": "856-988-6260",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DEMOSTHENES",
        "first_name": "NICHOLAS",
        "middle_name": "JAMES",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-04-16",
        "last_updated": "2024-09-04",
        "certification_date": "2024-09-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "NJ",
            "license": "25MA12120200",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ndemosthenes272227@directvirtua.org",
            "affiliation": "N",
            "address_1": "200 Bowman Dr Ste D160",
            "city": "Voorhees",
            "state": "NJ",
            "country_code": "US",
            "postal_code": "080439633",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ndemosthenes272227@directvirtua.org",
            "affiliation": "N",
            "address_1": "90 Brick Rd Fl Ground",
            "city": "Marlton",
            "state": "NJ",
            "country_code": "US",
            "postal_code": "080532177",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ndemosthenes272227@directvirtua.org",
            "affiliation": "N",
            "address_1": "100 Bowman Dr Fl 2",
            "city": "Voorhees",
            "state": "NJ",
            "country_code": "US",
            "postal_code": "080439612",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Voorhees, NJ

Sources for this page

Verify at the official NPI Registry.