Individual provider Active NPI

Patricia Marie Luceri, D.O.

  • Endocrinology, Diabetes & Metabolism Physician
  • Willingboro, NJ
National Provider Identifier
1538367198
Registry record updated Dec 4, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Endocrinology, Diabetes & Metabolism PhysicianTaxonomy code 207RE0101X
License
25MB08669700 Issued in NJ
Practice address
200 Campbell Dr Ste 115
Willingboro, NJ 08046-1067
Phone
(856) 536-1515
NPI assigned
Jul 5, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 4, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Endocrinology, Diabetes & Metabolism Physician 207RE0101X 051165 CT
Endocrinology, Diabetes & Metabolism Physician 207RE0101X 25MB08669700 NJ Primary

Addresses

Primary practice location

200 Campbell Dr Ste 115
Willingboro, NJ 08046-1067

Mailing address

1 Federal St Ste 200
Camden, NJ 08103-1088
Phone (848) 288-6935

Other practice location 1

25 E Laurel Rd
Stratford, NJ 08084-1322
Phone (856) 783-2664

Other names 1

  • Dr. Patricia Marie Mento Former name

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150108000669 NJ Practitioner - Endocrinology 6901053396 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Endocrinology
Education
Rowan University School of Osteopathic Medicine, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Cooper Care Alliance, PCGroup PAC ID 5890110563, 118 clinicians

Practice addresses (Care Compare)

200 Campbell Dr
Suite 115
Willingboro, NJ 08046-1067
Phone (856) 536-1515

Hospital & facility affiliations

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

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
25MB08669700NJMDEndocrinology, Diabetes & Metabolism Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Cooper Care Alliance, PC CurrentSince Jan 15, 2023 Accepting new patients
Kennedy Medical Group Practice, P.C. Endocrinology, Diabetes & Metabolism PastSince Jun 15, 2021 Accepting new patients
Family Physicians at Burlington Past Accepting new patients

Locations

1816 Route 541
Ste 102
Burlington, NJ 08016
Phone (609) 747-0870

63 Route 70 E
Marlton, NJ 08053
Phone (609) 748-5490

901 Route 168
Ste 210
Turnersville, NJ 08012
Phone (856) 227-1221

200 Campbell Dr
Ste 115
Willingboro, NJ 08046
Phone (609) 238-1078

Interoperability endpoints

  • Direct secure messaging: pluceri41717@direct.cooperhealth.edu

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": "1183593600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701648000000",
    "number": "1538367198",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 FEDERAL ST STE 200",
            "city": "CAMDEN",
            "state": "NJ",
            "postal_code": "081031088",
            "telephone_number": "848-288-6935"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 CAMPBELL DR STE 115",
            "city": "WILLINGBORO",
            "state": "NJ",
            "postal_code": "080461067",
            "telephone_number": "856-536-1515"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "25 E Laurel Rd",
            "address_purpose": "LOCATION",
            "city": "Stratford",
            "state": "NJ",
            "postal_code": "080841322",
            "country_code": "US",
            "telephone_number": "856-783-2664",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LUCERI",
        "first_name": "PATRICIA",
        "middle_name": "MARIE",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-07-05",
        "last_updated": "2023-12-04",
        "certification_date": "2023-12-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RE0101X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "CT",
            "license": "051165",
            "primary": false
        },
        {
            "code": "207RE0101X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "NJ",
            "license": "25MB08669700",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "PATRICIA",
            "last_name": "MENTO",
            "middle_name": "MARIE",
            "prefix": "DR.",
            "credential": "D.O.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Willingboro, NJ

Sources for this page

Verify at the official NPI Registry.