Individual provider Active NPI

Ellesse Credaroli, DO

  • Anesthesiology Physician
  • Camden, NJ
National Provider Identifier
1447789524
Registry record updated Jul 14, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
25MB13130000 Issued in NJ
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, 2026By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 14, 2026

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
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

TypeEndpointUseAffiliation
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, NJ4 enrollments
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 4

Enrollment IDStateProvider typePAC IDDetails
I20220914001333 MA Practitioner - Anesthesiology 1557632049 Reassigns benefits to 2 organizations
I20230726000414 PA Practitioner - Anesthesiology 1557632049 Reassigns benefits to 1 organization
I20250721000162 NH Practitioner - Anesthesiology 1557632049 Reassigns benefits to 2 organizations
I20260528002427 NJ Practitioner - AnesthesiologyPractitioner - Cardiovascular Disease (Cardiology) 1557632049

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Dartmouth-Hitchcock ClinicGroup PAC ID 4183537509, 1,445 clinicians
Virtua Medical Group, PAGroup PAC ID 9830222397, shared by 13 NPIs, 1,678 clinicians

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

LicenseStateTypeSpecialty
34432NHMDAnesthesiology Physician
25MB13130000NJMDAnesthesiology Physician
OS022704PAMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
The General Hospital Corporation CurrentSince Aug 1, 2022 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 CurrentSince Sep 1, 2023 Accepting new patients
Dartmouth-Hitchcock Clinic Anesthesiology CurrentSince Jul 15, 2025 Accepting new patients
Mary Hitchcock Memorial Hospital CurrentSince Jul 15, 2025 Accepting new patients
Mary Hitchcock Memorial Hospital CurrentSince Jul 15, 2025 Accepting new patients
Massachusetts General Physicians Organization Inc CurrentSince Aug 1, 2022 Accepting new patients
University of Penn-Medical Group CurrentSince Sep 1, 2023 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.

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": "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

Verify at the official NPI Registry.