Individual provider Active NPI

Suzanne H. Shenk, D.O.

  • Internal Medicine Physician
  • Stratford, NJ
National Provider Identifier
1447352364
Registry record updated Jun 14, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
25MB06177100 Issued in NJ
Practice address
42 E Laurel Rd Ste 3100-a
Stratford, NJ 08084-1354
Phone
(856) 566-7070
NPI assigned
Sep 1, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 14, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 25MB06177100 NJ Primary
Internal Medicine Physician 207R00000X MB61771 NJ

Addresses

Primary practice location

42 E Laurel Rd Ste 3100-a
Stratford, NJ 08084-1354

Mailing address

301 Lippincott Dr Ste 410
Marlton, NJ 08053-4197
Phone (565) 667-0708

Other practice location 1

1474 Tanyard Road
Suite B100-A
Sewell, NJ 08080
Phone (856) 566-6845

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address sshenk248994@directvirtua.org
Direct Messaging Address sshenk248994@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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080523000003 NJ Practitioner - Internal MedicinePractitioner - Osteopathic Manipulative Medicine 6406925932 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Michigan State University College of Osteopathic Medicine, 1987
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)

1474 Tanyard Rd
Sewell, NJ 08080-4222

3242 Route 206
Bordentown, NJ 08505-4517

42 E Laurel Rd
Stratford, NJ 08084-1354

Hospital & facility affiliations

  • Virtua Home Care at West Jersey Home health agency, Marlton, NJ, CCN 317071
  • Samaritan Healthcare and Hospice Hospice, Mount Laurel, NJ, CCN 311504
  • West Jersey Hospital Hospital, Voorhees, NJ, CCN 310022
  • Virtua Our Lady of Lourdes Hospital Hospital, Camden, NJ, CCN 310029

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
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
MB61771NJMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Virtua Medical Group, PA CurrentSince Jun 5, 2023 Accepting new patients
Virtua Medical Group, PA Internal Medicine CurrentSince Jun 5, 2023 Accepting new patients
Rowansom Newjersey Institute for Successful Aging-Geriatric Psychiatry Past Accepting new patients

Locations

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

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

303 Lippincott Dr
Marlton, NJ 08053

301 Lippincott Dr
Ste 410
Marlton, NJ 08053

1474 Tanyard Rd
Ste B100A
Sewell, NJ 08080
Phone (856) 566-6845

42 E Laurel Rd
Ste 3100A
Stratford, NJ 08084
Phone (856) 566-7070

42 E Laurel Rd
Ste 3100
Stratford, NJ 08084
Phone (856) 566-2753

Interoperability endpoints

  • Direct secure messaging: sshenk248994@directvirtua.org

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 and National Provider Directory roles.

Hospital & facility affiliations 4

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": "1157068800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718323200000",
    "number": "1447352364",
    "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": "565-667-0708",
            "fax_number": "856-566-7002"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "42 E LAUREL RD STE 3100-A",
            "city": "STRATFORD",
            "state": "NJ",
            "postal_code": "080841354",
            "telephone_number": "856-566-7070"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1474 Tanyard Road",
            "address_2": "Suite B100-A",
            "address_purpose": "LOCATION",
            "city": "Sewell",
            "state": "NJ",
            "postal_code": "08080",
            "country_code": "US",
            "telephone_number": "856-566-6845",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHENK",
        "first_name": "SUZANNE",
        "middle_name": "H.",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-01",
        "last_updated": "2024-06-14",
        "certification_date": "2024-06-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NJ",
            "license": "25MB06177100",
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NJ",
            "license": "MB61771",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "sshenk248994@directvirtua.org",
            "affiliation": "N",
            "address_1": "1474 Tanyard Road",
            "address_2": "Suite B100-A",
            "city": "Sewell",
            "state": "NJ",
            "country_code": "US",
            "postal_code": "08080",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "sshenk248994@directvirtua.org",
            "affiliation": "N",
            "address_1": "42 E Laurel Rd Ste 3100-A",
            "city": "Stratford",
            "state": "NJ",
            "country_code": "US",
            "postal_code": "080841354",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Stratford, NJ

Sources for this page

Verify at the official NPI Registry.