Individual provider Active NPI

Susan M Midili, APN

  • Nurse Practitioner
  • Pennsauken, NJ
National Provider Identifier
1487694774
Registry record updated Dec 5, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
NN104570 Issued in NJ
Practice address
7665 Maple Ave
Pennsauken, NJ 08109-3328
Phone
(856) 665-9520
Fax
(856) 665-6684
NPI assigned
Jun 7, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 5, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X NN104570 NJ Primary

Addresses

Primary practice location

7665 Maple Ave
Pennsauken, NJ 08109-3328

Mailing address

7665 Maple Ave
Pennsauken, NJ 08109-3328
Phone (856) 665-9520

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
I20050927001215 NJ Practitioner - Nurse Practitioner 3375583560 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Advocare, LLCGroup PAC ID 3678562188, 383 clinicians

Practice addresses (Care Compare)

175 Cross Keys Rd
Suite 300a
Berlin, NJ 08009-9263
Phone (856) 767-0077

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
NN104570NJMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Advocare , LLC CurrentSince Nov 18, 2019 Accepting new patients
Advocare, LLC CurrentSince Nov 18, 2019 Accepting new patients
Meridian Counseling Services, LLC Past Accepting new patients
Advocare, LLC Past Accepting new patients

Locations

339 N Route 73
Ste 1
Berlin, NJ 08009
Phone (856) 767-8228

132 Grove St
Ste A
Haddonfield, NJ 08033
Phone (856) 354-2211

401 Route 73 N
Ste 320
Marlton, NJ 08053
Phone (609) 471-1033

7665 Maple Ave
Pennsauken, NJ 08109
Phone (856) 665-9520

Interoperability endpoints

  • Direct secure messaging: susan.midili@advocaredoctors.eclinicaldirectplus.com

Organizations & group practices 4

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 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": "1149638400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1480896000000",
    "number": "1487694774",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7665 MAPLE AVE",
            "city": "PENNSAUKEN",
            "state": "NJ",
            "postal_code": "081093328",
            "telephone_number": "856-665-9520",
            "fax_number": "856-665-6684"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7665 MAPLE AVE",
            "city": "PENNSAUKEN",
            "state": "NJ",
            "postal_code": "081093328",
            "telephone_number": "856-665-9520",
            "fax_number": "856-665-6684"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MIDILI",
        "first_name": "SUSAN",
        "middle_name": "M",
        "credential": "APN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-07",
        "last_updated": "2016-12-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NJ",
            "license": "NN104570",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pennsauken, NJ

Sources for this page

Verify at the official NPI Registry.