Active NPI
Ellesse Credaroli, DO
- Anesthesiology Physician
- Camden, NJ
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Anesthesiology Physician
- License
- 25MB13130000
- Practice address
- 1600 Haddon Ave FL 3
Camden, NJ 08103-3101 - Phone
- (856) 988-6260
- Fax
- (856) 988-6270
- NPI assigned
- Jun 12, 2017
- Last updated
- Jul 14, 2026
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Anesthesiology Physician | 207L00000X | 34432 | NH | |
| Anesthesiology Physician | 207L00000X | 25MB13130000 | NJ | Primary |
| Anesthesiology Physician | 207L00000X | OS022704 | PA |
Addresses
Primary practice location
1600 Haddon Ave FL 3
Camden, NJ 08103-3101
Mailing address
301 Lippincott Dr Ste 410
Marlton, NJ 08053-4197
Phone (609) 988-6260
Other practice location 1
3400 Spruce Street
Philadelphia, PA 19104-4206
Phone (215) 349-8310
Other practice location 2
1 Medical Center Dr
Lebanon, NH 03756-0001
Phone (603) 650-5000
Electronic endpoints 2
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | ecredaroli325968@directvirtua.org | ||
| CONNECT URL | Boston | Health Information Exchange (HIE) |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MA, PA, NH, NJ
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 4
Care Compare profile
Medicare Care Compare- Specialty
- Anesthesiology
- Education
- Other, 2017
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Virtua Medical Group, PA
Practice addresses (Care Compare)
1 Medical Ctr Dr
Lebanon, NH 03756-1000
Phone (603) 650-5000
1600 Haddon Ave
FL 3
Camden, NJ 08103-3101
Phone (856) 757-3500
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 34432 | NH | MD | Anesthesiology Physician |
| 25MB13130000 | NJ | MD | Anesthesiology Physician |
| OS022704 | PA | MD | Anesthesiology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| The General Hospital Corporation | Current | Accepting new patients | |
| Mary Hitchcock Memorial Hospital | Current | Accepting new patients | |
| University of Penn-Medical Group | Current | Accepting new patients | |
| University of Penn-Medical Group | Current | Accepting new patients | |
| Dartmouth-Hitchcock Clinic | Anesthesiology | Current | Accepting new patients |
| Mary Hitchcock Memorial Hospital | Current | Accepting new patients | |
| Mary Hitchcock Memorial Hospital | Current | Accepting new patients | |
| Massachusetts General Physicians Organization Inc | Current | Accepting new patients | |
| University of Penn-Medical Group | Current | Accepting new patients |
Locations
55 Fruit St
Boston, MA 02114
55 Fruit St
#2
Boston, MA 02114
Phone (617) 726-2967
1 Medical Dr
Lebanon, NH 03756
Phone (603) 650-5922
3624 Market St
Fl 2
Philadelphia, PA 19104
Phone (215) 615-3669
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.
-
- General Acute Care Hospital
- Lebanon, NH
- NPI 1023092053
-
- Dermatology Physician
- Boston, MA
- NPI 1801874573
-
- General Acute Care Hospital
- Boston, MA
- NPI 1023049236
-
- Gynecologic Oncology Physician
- Philadelphia, PA
- NPI 1235527342
-
dba MHMH Regional Services
- General Acute Care Hospital
- Lebanon, NH
- NPI 1629788237
-
dba Hampstead Hospital
- Psychiatric Hospital
- Hampstead, NH
- NPI 1699584219
-
- Surgery Physician
- Philadelphia, PA
- NPI 1275921298
-
- Surgical Oncology Physician
- Philadelphia, PA
- NPI 1871981985
Hospital & facility affiliations 4
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
dba Virtua Our Lady of Lourdes Hospital
- General Acute Care Hospital
- Camden, NJ
- NPI 1235134024
-
- General Acute Care Hospital
- Lebanon, NH
- NPI 1023092053
-
dba MHMH Regional Services
- General Acute Care Hospital
- Lebanon, NH
- NPI 1629788237
-
dba Rutland Regional Medical Center
- General Acute Care Hospital
- Rutland, VT
- NPI 1720042203
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1497225600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1783987200000",
"number": "1447789524",
"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": "609-988-6260",
"fax_number": "856-988-6270"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1600 HADDON AVE FL 3",
"city": "CAMDEN",
"state": "NJ",
"postal_code": "081033101",
"telephone_number": "856-988-6260",
"fax_number": "856-988-6270"
}
],
"practiceLocations": [
{
"address_1": "3400 Spruce Street",
"address_purpose": "LOCATION",
"city": "Philadelphia",
"state": "PA",
"postal_code": "191044206",
"country_code": "US",
"telephone_number": "215-349-8310",
"fax_number": "215-893-7270",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "1 Medical Center Dr",
"address_purpose": "LOCATION",
"city": "Lebanon",
"state": "NH",
"postal_code": "037560001",
"country_code": "US",
"telephone_number": "603-650-5000",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "CREDAROLI",
"first_name": "ELLESSE",
"name_prefix": "Dr.",
"credential": "DO",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2017-06-12",
"last_updated": "2026-07-14",
"certification_date": "2026-07-14",
"status": "A"
},
"taxonomies": [
{
"code": "207L00000X",
"taxonomy_group": "",
"desc": "Anesthesiology",
"state": "NH",
"license": "34432",
"primary": false
},
{
"code": "207L00000X",
"taxonomy_group": "",
"desc": "Anesthesiology",
"state": "NJ",
"license": "25MB13130000",
"primary": true
},
{
"code": "207L00000X",
"taxonomy_group": "",
"desc": "Anesthesiology",
"state": "PA",
"license": "OS022704",
"primary": false
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "ecredaroli325968@directvirtua.org",
"affiliation": "N",
"address_1": "1600 Haddon Ave Fl 3",
"city": "Camden",
"state": "NJ",
"country_code": "US",
"postal_code": "081033101",
"country_name": "United States",
"address_type": "DOM"
},
{
"endpointType": "CONNECT",
"endpointTypeDescription": "CONNECT URL",
"endpoint": "Boston",
"affiliation": "N",
"use": "HIE",
"useDescription": "Health Information Exchange (HIE)",
"contentType": "CSV",
"contentTypeDescription": "CSV",
"address_1": "55 Fruit St Dept Of",
"city": "Boston",
"state": "MA",
"country_code": "US",
"postal_code": "021142696",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Camden, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.