Individual provider Active NPI

Marzena Villacorta

  • Gerontology Nurse Practitioner
  • Hamilton, NJ
National Provider Identifier
1386535946
Registry record updated Jul 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Nurse PractitionerTaxonomy code 363LG0600X
License
SP032763 Issued in PA
Practice address
3836 Quakerbridge Rd Ste 206
Hamilton, NJ 08619-1006
Phone
(563) 766-7014
NPI assigned
Jul 11, 2025
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 11, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gerontology Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363LG0600X SP032763 PA Primary

Addresses

Primary practice location

3836 Quakerbridge Rd Ste 206
Hamilton, NJ 08619-1006

Mailing address

5 Meade Dr
Hamilton, NJ 08619-3014

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
I20251218003604 NJ Practitioner - Nurse Practitioner 5597250365 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Princeton Sports and Family Medicine, P.C.Group PAC ID 4587710793, 16 clinicians

Practice addresses (Care Compare)

3131 Princeton Pike
BLDG 4a
Lawrenceville, NJ 08648-2201
Phone (609) 896-9190

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
SP032763PAMDGerontology Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Princeton Sports and Family Medicine, P.C. Single Specialty CurrentSince Nov 1, 2025 Accepting new patients
Quality Star Infusion Services LLC CurrentSince Dec 7, 2025 Accepting new patients

Locations

3131 Princeton Pike
Bldg 4A
Lawrenceville, NJ 08648
Phone (609) 896-9190

3131 Princeton Pike
Bldg 5
Lawrenceville, NJ 08648
Phone (609) 844-9661

3131 Princeton Pike
Bldg 4
Lawrenceville, NJ 08648
Phone (609) 896-4128

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/BHEFBA

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": "1752192000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1752192000000",
    "number": "1386535946",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5 MEADE DR",
            "city": "HAMILTON",
            "state": "NJ",
            "postal_code": "086193014"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3836 QUAKERBRIDGE RD STE 206",
            "city": "HAMILTON",
            "state": "NJ",
            "postal_code": "086191006",
            "telephone_number": "563-766-7014"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VILLACORTA",
        "first_name": "MARZENA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-07-11",
        "last_updated": "2025-07-11",
        "certification_date": "2025-07-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "PA",
            "license": "SP032763",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hamilton, NJ

Sources for this page

Verify at the official NPI Registry.