Individual provider Active NPI

Patricia C Pollan, MSN, APRN, BC

  • Adult Health Nurse Practitioner
  • Mount Laurel, NJ
National Provider Identifier
1396712121
Registry record updated Oct 18, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
26NJ00025800 Issued in NJ
Practice address
204 Ark Rd
Suite 103
Mount Laurel, NJ 08054-3100
Phone
(856) 778-4756
Fax
(856) 778-1742
NPI assigned
Mar 1, 2006
Last updated
Oct 18, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 18, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X 26NJ00025800 NJ Primary

Addresses

Primary practice location

204 Ark Rd
Suite 103
Mount Laurel, NJ 08054-3100

Mailing address

301 Lippincott Dr Ste 410
Marlton, NJ 08053-4197
Phone (856) 355-0340

Other practice location 1

401 Young Ave Ste 260A
Moorestown, NJ 08057-3130
Phone (856) 291-8756

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address ppollan14180@directvirtua.org
Direct Messaging Address ppollan14180@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
I20100901000958 NJ Practitioner - Nurse Practitioner 9133243819 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

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
Credentials
Master of Science - Nursing, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
26NJ00025800NJMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Virtua Medical Group, PA CurrentSince May 19, 2012 Accepting new patients
Virtua Medical Group, PA CurrentSince May 19, 2012 Accepting new patients
Northeastern Urological Associates Past Accepting new patients
Urologic Consultants of Southeastern Pennsylvania, LLP Past Accepting new patients

Locations

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

301 Lippincott Dr
Ste 410
Marlton, NJ 08053

401 Young Ave
Ste 260A
Moorestown, NJ 08057
Phone (856) 291-8756

Interoperability endpoints

  • Direct secure messaging: ppollan14180@directvirtua.org

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1141171200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1602979200000",
    "number": "1396712121",
    "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": "204 ARK RD",
            "address_2": "SUITE 103",
            "city": "MOUNT LAUREL",
            "state": "NJ",
            "postal_code": "080543100",
            "telephone_number": "856-778-4756",
            "fax_number": "856-778-1742"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "401 Young Ave Ste 260A",
            "address_purpose": "LOCATION",
            "city": "Moorestown",
            "state": "NJ",
            "postal_code": "080573130",
            "country_code": "US",
            "telephone_number": "856-291-8756",
            "fax_number": "856-291-8750",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "POLLAN",
        "first_name": "PATRICIA",
        "middle_name": "C",
        "credential": "MSN, APRN, BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-01",
        "last_updated": "2020-10-18",
        "certification_date": "2020-10-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NJ",
            "license": "26NJ00025800",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ppollan14180@directvirtua.org",
            "affiliation": "N",
            "address_1": "401 Young Ave Ste 260A",
            "city": "Moorestown",
            "state": "NJ",
            "country_code": "US",
            "postal_code": "080573130",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ppollan14180@directvirtua.org",
            "affiliation": "N",
            "address_1": "204 Ark Rd",
            "address_2": "Suite 103",
            "city": "Mount Laurel",
            "state": "NJ",
            "country_code": "US",
            "postal_code": "080543100",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Mount Laurel, NJ

Sources for this page

Verify at the official NPI Registry.