Individual provider Active NPI

Salvatore J Fogarino III, DPT

  • Sports Medicine (Physical Medicine & Rehabilitation) Physician
  • Sewell, NJ
National Provider Identifier
1457022329
Registry record updated Nov 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Medicine (Physical Medicine & Rehabilitation) PhysicianTaxonomy code 2081S0010X
License
40QA02162000 Issued in NJ
Practice address
570 Egg Harbor Rd Ste C-4C
Sewell, NJ 08080-2359
Phone
(609) 267-9400
NPI assigned
Sep 21, 2021
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 27, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Sports Medicine (Physical Medicine & Rehabilitation) Physician 2081S0010X 2305214700 VA
Sports Medicine (Physical Medicine & Rehabilitation) Physician 2081S0010X PT5000023 DC
Sports Medicine (Physical Medicine & Rehabilitation) Physician 2081S0010X 40QA02162000 NJ Primary

Addresses

Primary practice location

570 Egg Harbor Rd Ste C-4C
Sewell, NJ 08080-2359

Mailing address

301 Lippincott Dr Ste 410
Marlton, NJ 08053-4197
Phone (856) 355-0340

Other practice location 1

300 W Route 38 Ste C
Moorestown, NJ 08057-3424
Phone (609) 267-9400

Other practice location 2

614 Lambs Rd Unit C
Pitman, NJ 08071-2023
Phone (609) 267-9400

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240319004218 NJ Practitioner - Physical Therapist in Private Practice 2567853740 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Virtua Medical Group, PAGroup PAC ID 9830222397, 1,678 clinicians

Practice addresses (Care Compare)

3242 Route 206
Bordentown, NJ 08505-4517

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

State licenses

LicenseStateTypeSpecialty
40QA02162000NJMDSports Medicine (Physical Medicine & Rehabilitation) Physician
2305214700VAMDSports Medicine (Physical Medicine & Rehabilitation) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Virtua Medical Group, PA CurrentSince Dec 3, 2023 Accepting new patients
Virtua Medical Group, PA CurrentSince Jan 23, 2024 Accepting new patients
Virtua Medical Group, PA CurrentSince Jan 23, 2024 Accepting new patients

Locations

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

301 Lippincott Dr
Ste 410
Marlton, NJ 08053

303 Lippincott Dr
Ste 200
Marlton, NJ 08053
Phone (856) 355-0335

300 W Route 38
Ste C
Moorestown, NJ 08057

614 Lambs Rd
Unit C
Pitman, NJ 08071
Phone (856) 256-0051

570 Egg Harbor Rd
Ste C4C
Sewell, NJ 08080

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.

NPI Registry JSON

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

{
    "created_epoch": "1632182400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701043200000",
    "number": "1457022329",
    "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": "856-355-0340"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "570 EGG HARBOR RD STE C-4C",
            "city": "SEWELL",
            "state": "NJ",
            "postal_code": "080802359",
            "telephone_number": "609-267-9400"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "300 W Route 38 Ste C",
            "address_purpose": "LOCATION",
            "city": "Moorestown",
            "state": "NJ",
            "postal_code": "080573424",
            "country_code": "US",
            "telephone_number": "609-267-9400",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "614 Lambs Rd Unit C",
            "address_purpose": "LOCATION",
            "city": "Pitman",
            "state": "NJ",
            "postal_code": "080712023",
            "country_code": "US",
            "telephone_number": "609-267-9400",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FOGARINO",
        "first_name": "SALVATORE",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "name_suffix": "III",
        "credential": "DPT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-09-21",
        "last_updated": "2023-11-27",
        "certification_date": "2023-11-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2081S0010X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation, Sports Medicine",
            "state": "VA",
            "license": "2305214700",
            "primary": false
        },
        {
            "code": "2081S0010X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation, Sports Medicine",
            "state": "DC",
            "license": "PT5000023",
            "primary": false
        },
        {
            "code": "2081S0010X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation, Sports Medicine",
            "state": "NJ",
            "license": "40QA02162000",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sewell, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 27, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.

Verify at the official NPI Registry.