Michelle M Vital, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

25MA07788900 Issued in NJ

Practice address

1601 Haddon Ave
Camden, NJ 08103

Phone

(856) 796-3500

Fax

(856) 365-7972

NPI assigned

Mar 8, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 2

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir-api.fhirprod.aws.greenwayhealth.com/fhir/R4/2.16.840.1.113883.3.140.72983
• Direct secure messaging: mvital@osbornfhc.directbygreenway.com
• Direct secure messaging: mvital167376@directvirtua.org

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.

• The Osborn Family Health Center, Inc.

  • Family Medicine Physician
  • Camden, NJ
  • NPI 1528444254

  Pediatrics

  Medicare reassignment NPD
• The Osborn Family Health Center, Inc.

  • Federally Qualified Health Center (FQHC)
  • Camden, NJ
  • NPI 1730695305
  NPD
• The Cooper Health System

  • General Acute Care Hospital
  • Camden, NJ
  • NPI 1568442309
  NPD (past)
• Virtua Our Lady of Lourdes Hospital Inc

  • General Acute Care Hospital
  • Camden, NJ
  • NPI 1235134024
  NPD (past)

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

{
    "created_epoch": "1141776000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1386612380",
    "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",
            "fax_number": "856-355-0330"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1601 HADDON AVE",
            "city": "CAMDEN",
            "state": "NJ",
            "postal_code": "08103",
            "telephone_number": "856-796-3500",
            "fax_number": "856-365-7972"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VITAL",
        "first_name": "MICHELLE",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-08",
        "last_updated": "2023-03-07",
        "certification_date": "2021-02-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NJ",
            "license": "25MA07788900",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NJ MEDICAL LICENSE",
            "identifier": "25MA07788900",
            "state": "NJ"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mvital167376@directvirtua.org",
            "affiliation": "N",
            "address_1": "1600 Haddon Ave Fl 3",
            "city": "Camden",
            "state": "NJ",
            "country_code": "US",
            "postal_code": "081033101",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mvital167376@directvirtua.org",
            "affiliation": "N",
            "address_1": "1601 Haddon Ave",
            "city": "Camden",
            "state": "NJ",
            "country_code": "US",
            "postal_code": "08103",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Vip Transportation Services, Inc.
• Bianca Virgilio, CRNA
• Virtua Our Lady of Lourdes Hospital Inc
• Virtua Our Lady of Lourdes Hospital, Inc.
• Amba Viswanathan
• Kayla Vitale, CRNA
• Robert Vitale, CRNA
• Melanie Vizzachero
• Nora Jean Rhoads Vizzachero, MSN, APN-C
• Tudor J. Vlad, M.D.

• Pediatrics Physician in Camden, NJ
• Providers in Camden, NJ by specialty
• Pediatrics Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.