Individual provider Active NPI

Fatima Alexandra Bardales-Delgado, PA-C

  • Physician Assistant
  • Voorhees, NJ
National Provider Identifier
1467040998
Registry record updated Jan 18, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
25MP00649500 Issued in NJ
Practice address
100 Bowman Dr Lowr Level1
Voorhees, NJ 08043-9612
Phone
(856) 247-3000
Fax
(856) 247-2597
NPI assigned
Jan 10, 2021
Last updated
Jan 18, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 18, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 25MP00649500 NJ Primary
Student in an Organized Health Care Education/Training Program 390200000X NU

Addresses

Primary practice location

100 Bowman Dr Lowr Level1
Voorhees, NJ 08043-9612

Mailing address

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

Other practice location 1

90 Brick Rd
Marlton, NJ 08053-2177
Phone (856) 355-6000

Other practice location 2

1600 Haddon Ave Fl 6
Camden, NJ 08103-3101
Phone (856) 757-3500

Other practice location 3

218 Sunset Rd Fl 5
Willingboro, NJ 08046-1110
Phone (609) 835-3056

Other practice location 4

175 Madison Ave
Mount Holly, NJ 08060-2038
Phone (609) 914-6000

Electronic endpoints 5

TypeEndpointUseAffiliation
Direct Messaging Address fbardalesdelgado208595@directvirtua.org
Direct Messaging Address fbardalesdelgado208595@directvirtua.org
Direct Messaging Address fbardalesdelgado208595@directvirtua.org
Direct Messaging Address fbardalesdelgado208595@directvirtua.org
Direct Messaging Address fbardalesdelgado208595@directvirtua.org

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
I20211118001990 NJ Practitioner - Physician Assistant 9537558226 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Heymann, Manders, Green and Sommer, LLC.Group PAC ID 3476595505, 14 clinicians

Practice addresses (Care Compare)

10000 Sagemore Dr
Suite 10101
Marlton, NJ 08053-3944
Phone (856) 596-0111

640 S White Horse Pike
Hammonton, NJ 08037-2014
Phone (856) 596-0111

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Promoting interoperability
100
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
99.52 of 100Reported as apm
Quality
81.58
Promoting interoperability
99.4
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
25MP00649500NJMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Virtua Medical Group, PA CurrentSince Dec 1, 2021 Accepting new patients
Virtua Medical Group, PA Physician Assistant CurrentSince Dec 1, 2021 Accepting new patients
Virtua Medical Group, PA Past Accepting new patients

Locations

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

1600 Haddon Ave
Fl 6
Camden, NJ 08103
Phone (856) 247-2160

301 Lippincott Dr
Ste 410
Marlton, NJ 08053

90 Brick Rd
Marlton, NJ 08053
Phone (856) 355-6040

175 Madison Ave
Mount Holly, NJ 08060
Phone (609) 261-1660

100 Bowman Dr
Lowr
Voorhees, NJ 08043
Phone (856) 247-2160

218 Sunset Rd
Fl 5
Willingboro, NJ 08046
Phone (609) 444-0359

Interoperability endpoints

  • Direct secure messaging: fbardalesdelgado208595@directvirtua.org

Organizations & group practices 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1610236800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1642464000000",
    "number": "1467040998",
    "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",
            "fax_number": "856-355-0330"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 BOWMAN DR LOWR LEVEL1",
            "city": "VOORHEES",
            "state": "NJ",
            "postal_code": "080439612",
            "telephone_number": "856-247-3000",
            "fax_number": "856-247-2597"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "90 Brick Rd",
            "address_purpose": "LOCATION",
            "city": "Marlton",
            "state": "NJ",
            "postal_code": "080532177",
            "country_code": "US",
            "telephone_number": "856-355-6000",
            "fax_number": "856-355-6731",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1600 Haddon Ave Fl 6",
            "address_purpose": "LOCATION",
            "city": "Camden",
            "state": "NJ",
            "postal_code": "081033101",
            "country_code": "US",
            "telephone_number": "856-757-3500",
            "fax_number": "856-365-4088",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "218 Sunset Rd Fl 5",
            "address_purpose": "LOCATION",
            "city": "Willingboro",
            "state": "NJ",
            "postal_code": "080461110",
            "country_code": "US",
            "telephone_number": "609-835-3056",
            "fax_number": "609-835-5741",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "175 Madison Ave",
            "address_purpose": "LOCATION",
            "city": "Mount Holly",
            "state": "NJ",
            "postal_code": "080602038",
            "country_code": "US",
            "telephone_number": "609-914-6000",
            "fax_number": "609-914-6182",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BARDALES-DELGADO",
        "first_name": "FATIMA",
        "middle_name": "ALEXANDRA",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-01-10",
        "last_updated": "2022-01-18",
        "certification_date": "2022-01-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NJ",
            "license": "25MP00649500",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "fbardalesdelgado208595@directvirtua.org",
            "affiliation": "N",
            "address_1": "90 Brick Rd",
            "city": "Marlton",
            "state": "NJ",
            "country_code": "US",
            "postal_code": "080532177",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "fbardalesdelgado208595@directvirtua.org",
            "affiliation": "N",
            "address_1": "1600 Haddon Ave Fl 6",
            "city": "Camden",
            "state": "NJ",
            "country_code": "US",
            "postal_code": "081033101",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "fbardalesdelgado208595@directvirtua.org",
            "affiliation": "N",
            "address_1": "175 Madison Ave",
            "city": "Mount Holly",
            "state": "NJ",
            "country_code": "US",
            "postal_code": "080602038",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "fbardalesdelgado208595@directvirtua.org",
            "affiliation": "N",
            "address_1": "218 Sunset Rd Fl 5",
            "city": "Willingboro",
            "state": "NJ",
            "country_code": "US",
            "postal_code": "080461110",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "fbardalesdelgado208595@directvirtua.org",
            "affiliation": "N",
            "address_1": "100 Bowman Dr Lowr Level1",
            "city": "Voorhees",
            "state": "NJ",
            "country_code": "US",
            "postal_code": "080439612",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Voorhees, NJ

Sources for this page

Verify at the official NPI Registry.