Individual provider Active NPI

Erin Beth Fiacco, CRNP

  • Family Nurse Practitioner
  • Mullica Hill, NJ
National Provider Identifier
1407346893
Registry record updated Nov 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
26NJ15194100 Issued in NJ
Practice address
4 Burton LN Ste 100
Mullica Hill, NJ 08062-9441
Phone
(856) 241-3838
NPI assigned
May 11, 2018
Last updated
Nov 19, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 19, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X SP018862 PA
Family Nurse Practitioner 363LF0000X 26NJ15194100 NJ Primary

Addresses

Primary practice location

4 Burton LN Ste 100
Mullica Hill, NJ 08062-9441

Mailing address

4 Burton LN Ste 100
Mullica Hill, NJ 08062-9441
Phone (856) 241-3838

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA, NJ2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20190717000014 PA Practitioner - Nurse Practitioner 1951636752 Reassigns benefits to 1 organization
I20241118003415 NJ Practitioner - Nurse Practitioner 1951636752 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Advanced Cardiology of South JerseyGroup PAC ID 2466461678, 4 clinicians

Practice addresses (Care Compare)

4 Burton LN
Suite 100
Mullica Hill, NJ 08062-9441
Phone (856) 241-3838

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science - Nursing, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
26NJ15194100NJMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Advanced Cardiology of South Jersey CurrentSince Nov 11, 2024 Accepting new patients
David a Thomas, LTD CurrentSince May 11, 2019 Accepting new patients
David a Thomas, LTD CurrentSince May 11, 2019 Accepting new patients
Custom Sleep Therapies PC PastSince Nov 11, 2024 Accepting new patients

Locations

4 Burton Ln
Ste 100
Mullica Hill, NJ 08062
Phone (856) 241-3838

Interoperability endpoints

  • Direct secure messaging: erin.fiacco@advancedcardiologyofsouthjersey.chartmakerdirect.com

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.

Hospital & facility affiliations 2

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": "1525996800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731974400000",
    "number": "1407346893",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4 BURTON LN STE 100",
            "city": "MULLICA HILL",
            "state": "NJ",
            "postal_code": "080629441",
            "telephone_number": "856-241-3838"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4 BURTON LN STE 100",
            "city": "MULLICA HILL",
            "state": "NJ",
            "postal_code": "080629441",
            "telephone_number": "856-241-3838"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FIACCO",
        "first_name": "ERIN",
        "middle_name": "BETH",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-05-11",
        "last_updated": "2024-11-19",
        "certification_date": "2024-11-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "PA",
            "license": "SP018862",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NJ",
            "license": "26NJ15194100",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mullica Hill, NJ

Sources for this page

Verify at the official NPI Registry.