NPIMap

Individual provider Active NPI

Michael Meltzer, DO

  • Family Medicine Physician
  • Hainesport, NJ
National Provider Identifier
1396784047
Registry record updated Oct 19, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
25MB06640200 Issued in NJ
Practice address
310 Creek Crossing Blvd
Hainesport, NJ 08036-2767
Phone
(609) 702-0014
Fax
(609) 702-7225
NPI assigned
Jun 6, 2006
Last updated
Oct 19, 2020By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 19, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 25MB06640200 NJ Primary

Addresses

Primary practice location

310 Creek Crossing Blvd
Hainesport, NJ 08036-2767

Mailing address

500 Grove St
Suite 100
Haddon Heights, NJ 08035-1761
Phone (856) 323-1225

Other identifiers 1

IdentifierTypeStateIssuer
8185506MedicaidNJ

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address mmeltzer167097@directvirtua.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110308000373 NJ Practitioner - Family Practice 3375725641 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Virtua Medical Group, PAGroup PAC ID 9830222397, 1,678 clinicians

Practice addresses (Care Compare)

310 Creek Crossing Blvd
Hainesport, NJ 08036-2767
Phone (609) 702-0014

3242 Route 206
Bordentown, NJ 08505-4517

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
25MB06640200NJMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Virtua Medical Group, PA CurrentSince Nov 1, 2020 Accepting new patients
Virtua Medical Group, PA CurrentSince Nov 1, 2020 Accepting new patients
Virtua Medical Group, PA Family Medicine Current Accepting new patients
Alliance for Better Care, P.C. Family Medicine Past Accepting new patients
Virtua Willingboro Hospital Inc Past Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients
Virtua - Memorial Hospital Burlington County, Inc. Past Accepting new patients
Virtua - West Jersey Health System, Inc. Past 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

310 Creek Crossing Blvd
Hainesport, NJ 08036
Phone (609) 702-0014

1613 Route 38
Lumberton, NJ 08048
Phone (609) 261-3716

141 Route 70 E
Ste E
Marlton, NJ 08053
Phone (856) 985-7373

303 Lippincott Dr
Marlton, NJ 08053

Interoperability endpoints

  • FHIR API: https://epicproxy.et1017.epichosted.com/FHIRProxy/api/FHIR/R4

Organizations & group practices 9

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 12

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": "1149552000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603065600000",
    "number": "1396784047",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 GROVE ST",
            "address_2": "SUITE 100",
            "city": "HADDON HEIGHTS",
            "state": "NJ",
            "postal_code": "080351761",
            "telephone_number": "856-323-1225",
            "fax_number": "856-796-9397"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "310 CREEK CROSSING BLVD",
            "city": "HAINESPORT",
            "state": "NJ",
            "postal_code": "080362767",
            "telephone_number": "609-702-0014",
            "fax_number": "609-702-7225"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MELTZER",
        "first_name": "MICHAEL",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-06-06",
        "last_updated": "2020-10-19",
        "certification_date": "2020-10-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NJ",
            "license": "25MB06640200",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8185506",
            "state": "NJ"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mmeltzer167097@directvirtua.org",
            "affiliation": "N",
            "address_1": "310 Creek Crossing Blvd",
            "city": "Hainesport",
            "state": "NJ",
            "country_code": "US",
            "postal_code": "080362767",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Hainesport, NJ

Sources for this page

Verify at the official NPI Registry.