Individual provider Active NPI

Angela Theresa Marinucci, NP

  • Family Nurse Practitioner
  • Vineland, NJ
National Provider Identifier
1447276431
Registry record updated Sep 22, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
26NJ00057800 Issued in NJ
Practice address
1527 Forest Grove Rd
Vineland, NJ 08360-1865
Phone
(856) 697-7490
Fax
(856) 697-7494
NPI assigned
Jul 14, 2006
Last updated
Sep 22, 2010By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 22, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 26NJ00057800 NJ Primary

Addresses

Primary practice location

1527 Forest Grove Rd
Vineland, NJ 08360-1865

Mailing address

414 Hancock Dr
Mullica Hill, NJ 08062-1828
Phone (856) 223-0908

Other identifiers 1

IdentifierTypeStateIssuer
0031313MedicaidNJ

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
I20040802000323 NJ Practitioner - Nurse Practitioner 8921079369 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Samaritan Homevisit Physicians PCGroup PAC ID 8820423163, 11 clinicians

Practice addresses (Care Compare)

3906 Church Rd
Mount Laurel, NJ 08054-1108
Phone (856) 596-1600

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
26NJ00057800NJMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Samaritan Homevisit Physicians PC CurrentSince Dec 1, 2019 Accepting new patients
Samaritan Healthcare & Hospice, Inc. Past Accepting new patients
Developmental Disabilities Health Alliance, Inc Past Accepting new patients

Locations

282 Chester Ave
Moorestown, NJ 08057
Phone (856) 222-3292

3906 Church Rd
Mount Laurel, NJ 08054
Phone (856) 222-3292

3906 Church Rd
Ste 100
Mount Laurel, NJ 08054

480 Woodlane Rd
Westampton, NJ 08060
Phone (609) 877-0555

Interoperability endpoints

  • Direct secure messaging: angelamarinucci@a39faffc.micromddirect.com

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 5

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": "1152835200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1285113600000",
    "number": "1447276431",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "414 HANCOCK DR",
            "city": "MULLICA HILL",
            "state": "NJ",
            "postal_code": "080621828",
            "telephone_number": "856-223-0908"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1527 FOREST GROVE RD",
            "city": "VINELAND",
            "state": "NJ",
            "postal_code": "083601865",
            "telephone_number": "856-697-7490",
            "fax_number": "856-697-7494"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARINUCCI",
        "first_name": "ANGELA",
        "middle_name": "THERESA",
        "name_prefix": "Mrs.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-14",
        "last_updated": "2010-09-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NJ",
            "license": "26NJ00057800",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0031313",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Vineland, NJ

Sources for this page

Verify at the official NPI Registry.