NPIMap

Organization Active NPI

Rancocas Anesthesiology, P.a.

  • Specialist
  • Mount Laurel, NJ
National Provider Identifier
1427076553
Registry record updated Jun 12, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
Legal business name
RANCOCAS ANESTHESIOLOGY, P.A.
Practice address
15000 Midlantic Dr
Mount Laurel, NJ 08054-1573
Phone
(856) 829-9345
Fax
(856) 829-3605
NPI assigned
Jul 17, 2006
Last updated
Jun 12, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 12, 2012

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

Authorized official

Name
Ms. Roberta Lynne Catullo, R.N.NPI 1457907354
Title
Compliance Officer
Phone
(856) 829-9345

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X Primary

Addresses

Primary practice location

15000 Midlantic Dr
Mount Laurel, NJ 08054-1573

Mailing address

PO Box 1568
Mount Laurel, NJ 08054-7568
Phone (856) 829-9345

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040330000316 PA Part B Supplier - Clinic/Group Practice 2769380237 Receives reassigned benefits from 55 practitioners
Practice locations: Bala Cynwyd, PA

National Provider Directory

National Provider Directory

Locations

2090 Springdale Rd
Ste A
Cherry Hill, NJ 08003
Phone (856) 488-6832

2211 Chapel Ave W
Ste 200
Cherry Hill, NJ 08002
Phone (856) 295-9032

150 Century Pkwy
Mount Laurel, NJ 08054
Phone (609) 642-4202

40 Monument Rd
Fl 5
Bala Cynwyd, PA 19004
Phone (610) 667-6760

Practitioners & affiliated clinicians

Practitioners 158

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 158

NPI Registry JSON

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

{
    "created_epoch": "1153094400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1339459200000",
    "number": "1427076553",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1568",
            "city": "MOUNT LAUREL",
            "state": "NJ",
            "postal_code": "080547568",
            "telephone_number": "856-829-9345",
            "fax_number": "856-829-3605"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15000 MIDLANTIC DR",
            "city": "MOUNT LAUREL",
            "state": "NJ",
            "postal_code": "080541573",
            "telephone_number": "856-829-9345",
            "fax_number": "856-829-3605"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RANCOCAS ANESTHESIOLOGY, P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-17",
        "last_updated": "2012-06-12",
        "status": "A",
        "authorized_official_last_name": "CATULLO",
        "authorized_official_first_name": "ROBERTA",
        "authorized_official_middle_name": "LYNNE",
        "authorized_official_title_or_position": "COMPLIANCE OFFICER",
        "authorized_official_telephone_number": "856-829-9345",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "R.N."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mount Laurel, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.