Individual provider Active NPI

Kelly Marie Caruso, ACNP

  • Acute Care Nurse Practitioner
  • Burlington, NJ
National Provider Identifier
1396172797
Registry record updated Oct 20, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
26NJ00449700 Issued in NJ
Practice address
329 Fernwood Ave
Burlington, NJ 08016-2508
Phone
(609) 864-0353
NPI assigned
Sep 30, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 20, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X 26NJ00449700 NJ Primary

Addresses

Primary practice location

329 Fernwood Ave
Burlington, NJ 08016-2508

Mailing address

329 Fernwood Avenue
Burlington, NJ 08016
Phone (609) 864-0353

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address kcaruso18573@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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140102000070 NJ Practitioner - Nurse Practitioner 0840428561 Reassigns benefits to 2 organizations

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
Virtua Medical Group, PAGroup PAC ID 9830222397, 1,678 clinicians

Practice addresses (Care Compare)

100 Bowman Dr
Voorhees, NJ 08043-9612
Phone (856) 247-3328

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
81.15 of 100Reported as group
Quality
62.28
Promoting interoperability
100
Improvement activities
40
Cost
74.89

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
26NJ00449700NJMDAcute Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Virtua Medical Group, PA CurrentSince Sep 1, 2018 Accepting new patients
Virtua Medical Group, PA CurrentSince Sep 1, 2018 Accepting new patients
Robert J Maro MD PA CurrentSince Sep 1, 2014 Accepting new patients

Locations

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

1600 Haddon Ave
Camden, NJ 08103
Phone (609) 757-3500

701 Cooper Rd
Ste 16
Voorhees, NJ 08043
Phone (856) 429-2224

100 Bowman Dr
Fl 1
Voorhees, NJ 08043
Phone (856) 247-2645

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 3

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": "1380499200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603152000000",
    "number": "1396172797",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "329 FERNWOOD AVENUE",
            "city": "BURLINGTON",
            "state": "NJ",
            "postal_code": "08016",
            "telephone_number": "609-864-0353"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "329 FERNWOOD AVE",
            "city": "BURLINGTON",
            "state": "NJ",
            "postal_code": "080162508",
            "telephone_number": "609-864-0353"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARUSO",
        "first_name": "KELLY",
        "middle_name": "MARIE",
        "name_prefix": "Ms.",
        "credential": "ACNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-09-30",
        "last_updated": "2020-10-20",
        "certification_date": "2020-10-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "NJ",
            "license": "26NJ00449700",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kcaruso18573@directvirtua.org",
            "affiliation": "N",
            "address_1": "100 Bowman Dr Fl 1",
            "city": "Voorhees",
            "state": "NJ",
            "country_code": "US",
            "postal_code": "080439612",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Burlington, NJ

Sources for this page

Verify at the official NPI Registry.