Individual provider Active NPI

Staci K Oertle, ANP-BC

  • Adult Health Nurse Practitioner
  • Camden, NJ
National Provider Identifier
1457697294
Registry record updated Oct 29, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
26NJ00397400 Issued in NJ
Practice address
2 Cooper PLZ
400 Haddon Ave
Camden, NJ 08103-1461
Phone
(855) 632-2667
NPI assigned
Dec 26, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 29, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X 26NJ00397400 NJ Primary

Addresses

Primary practice location

2 Cooper PLZ
400 Haddon Ave
Camden, NJ 08103-1461

Mailing address

1 Federal Street
Sw200
Camden, NJ 08103-1155
Phone (856) 356-4924

Other practice location 1

1505 W Sherman Ave
Vineland, NJ 08360-6912
Phone (856) 641-7988

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
I20161006001661 NJ Practitioner - Nurse Practitioner 5294023206 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
CMC Department of Medicine Group PAGroup PAC ID 2163335878, 474 clinicians

Practice addresses (Care Compare)

900 Centennial Blvd M
Voorhees, NJ 08043-4637
Phone (856) 325-6750

Hospital & facility affiliations

  • Cooper University Hospital Hospital, Camden, NJ, CCN 310014

Merit-based Incentive Payment System (MIPS)

Final score
91.83 of 100Reported as group
Quality
88.78
Promoting interoperability
99
Improvement activities
40
Cost
74.17

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
26NJ00397400NJMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
CMC Department of Medicine Group PA CurrentSince Aug 14, 2016 Accepting new patients
CMC Department of Medicine Group PA CurrentSince Aug 14, 2016 Accepting new patients

Locations

3 Cooper Plz
Rm 215
Camden, NJ 08103
Phone (856) 342-2439

2 Cooper Plz
#400
Camden, NJ 08103
Phone (856) 342-2300

2 Cooper Plz
Camden, NJ 08103
Phone (609) 342-7600

1 Federal St
Ste SW200
Camden, NJ 08103
Phone (856) 356-4920

1 Plaza Dr
Ste 103
Sewell, NJ 08080
Phone (856) 270-4080

1 Plaza Dr
Sewell, NJ 08080
Phone (856) 270-4080

1505 W Sherman Ave
Vineland, NJ 08360
Phone (856) 451-6600

900 Centennial Blvd
Ste M
Voorhees, NJ 08043
Phone (856) 325-6750

Interoperability endpoints

  • Direct secure messaging: soertle51468@direct.cooperhealth.edu

Organizations & group practices 2

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": "1356480000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603929600000",
    "number": "1457697294",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 FEDERAL STREET",
            "address_2": "SW200",
            "city": "CAMDEN",
            "state": "NJ",
            "postal_code": "081031155",
            "telephone_number": "856-356-4924"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 COOPER PLZ",
            "address_2": "400 HADDON AVE",
            "city": "CAMDEN",
            "state": "NJ",
            "postal_code": "081031461",
            "telephone_number": "855-632-2667"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1505 W Sherman Ave",
            "address_purpose": "LOCATION",
            "city": "Vineland",
            "state": "NJ",
            "postal_code": "083606912",
            "country_code": "US",
            "telephone_number": "856-641-7988",
            "fax_number": "856-641-7655",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "OERTLE",
        "first_name": "STACI",
        "middle_name": "K",
        "name_prefix": "Mrs.",
        "credential": "ANP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-12-26",
        "last_updated": "2020-10-29",
        "certification_date": "2020-10-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NJ",
            "license": "26NJ00397400",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Camden, NJ

Sources for this page

Verify at the official NPI Registry.