Individual provider Active NPI

Lisa Marie Campenella, PA-C

  • Surgical Physician Assistant
  • Marlton, NJ
National Provider Identifier
1457374639
Registry record updated Feb 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
25MP00132100 Issued in NJ
Practice address
25 John James Audubon Way Ste 410
Marlton, NJ 08053-7219
Phone
(856) 701-4485
NPI assigned
Jul 26, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 27, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X MA051861 PA
Surgical Physician Assistant 363AS0400X 25MP00132100 NJ Primary

Addresses

Primary practice location

25 John James Audubon Way Ste 410
Marlton, NJ 08053-7219

Mailing address

25 John James Audubon Way
Marlton, NJ 08053-7219
Phone (856) 701-4485

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
I20070411000181 NJ Practitioner - Physician Assistant 0042243586 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2004
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)

131 Route 70
Suite 100
Medford, NJ 08055-9501
Phone (856) 673-3960

3242 Route 206
Bordentown, NJ 08505-4517

Hospital & facility affiliations

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
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Virtua Medical Group, PA CurrentSince Nov 1, 2020 Accepting new patients
Virtua Medical Group, PA CurrentSince Nov 1, 2020 Accepting new patients
Virtua Medical Group, PA PastSince Sep 1, 2020 Accepting new patients

Locations

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

1 Brace Rd
Ste B3
Cherry Hill, NJ 08034
Phone (856) 470-9029

301 Lippincott Dr
Ste 410
Marlton, NJ 08053

300 W Route 38
Ste B
Moorestown, NJ 08057
Phone (856) 295-9985

300 W Route 38
Moorestown, NJ 08057
Phone 60926794001224

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 2

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": "1153872000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1677456000000",
    "number": "1457374639",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25 JOHN JAMES AUDUBON WAY",
            "city": "MARLTON",
            "state": "NJ",
            "postal_code": "080537219",
            "telephone_number": "856-701-4485"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25 JOHN JAMES AUDUBON WAY STE 410",
            "city": "MARLTON",
            "state": "NJ",
            "postal_code": "080537219",
            "telephone_number": "856-701-4485"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CAMPENELLA",
        "first_name": "LISA",
        "middle_name": "MARIE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-26",
        "last_updated": "2023-02-27",
        "certification_date": "2023-02-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "PA",
            "license": "MA051861",
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "NJ",
            "license": "25MP00132100",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Marlton, NJ

Sources for this page

Verify at the official NPI Registry.