Individual provider Active NPI

Alicemarie Poyss, APN,C

  • Acute Care Nurse Practitioner
  • Marlton, NJ
National Provider Identifier
1568580595
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
26NN06596800 Issued in NJ
Practice address
767 E Route 70
Suite B-101
Marlton, NJ 08053-2341
Phone
(856) 983-9939
Fax
(856) 983-9936
NPI assigned
Mar 27, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X 26NN06596800 NJ Primary
Acute Care Nurse Practitioner 363LA2100X SP004161M PA

Addresses

Primary practice location

767 E Route 70
Suite B-101
Marlton, NJ 08053-2341

Mailing address

20 Robin Hood Dr
Medford, NJ 08055-8525
Phone (609) 654-0946

Other identifiers 1

IdentifierTypeStateIssuer
8882002MedicaidNJ

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
I20050330000009 NJ Practitioner - Nurse Practitioner 9537115886 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
SP004161MPAMDAcute Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Elmwood Family Physicians CurrentSince Jan 19, 2005 Accepting new patients

Locations

777 Route 70 E
Ste G101
Marlton, NJ 08053
Phone (856) 818-4020

767 Route 70 E
Ste B101
Marlton, NJ 08053
Phone (856) 983-9939

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1174953600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1568580595",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20 ROBIN HOOD DR",
            "city": "MEDFORD",
            "state": "NJ",
            "postal_code": "080558525",
            "telephone_number": "609-654-0946",
            "fax_number": "609-953-1825"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "767 E ROUTE 70",
            "address_2": "SUITE B-101",
            "city": "MARLTON",
            "state": "NJ",
            "postal_code": "080532341",
            "telephone_number": "856-983-9939",
            "fax_number": "856-983-9936"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POYSS",
        "first_name": "ALICEMARIE",
        "name_prefix": "Ms.",
        "credential": "APN,C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-27",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "NJ",
            "license": "26NN06596800",
            "primary": true
        },
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "PA",
            "license": "SP004161M",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8882002",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Marlton, NJ

Sources for this page

Verify at the official NPI Registry.