Individual provider Active NPI

Samantha Ellen Collazo, MD

  • Obstetrics & Gynecology Physician
  • Westampton, NJ
National Provider Identifier
1588161293
Registry record updated Oct 4, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
25MA11395800 Issued in NJ
Practice address
101 Burrs Rd Ste a&B
Westampton, NJ 08060-5517
Phone
(609) 261-0240
NPI assigned
Apr 9, 2018
Last updated
Oct 4, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 4, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X NU
Obstetrics & Gynecology Physician 207V00000X 25MA11395800 NJ Primary

Addresses

Primary practice location

101 Burrs Rd Ste a&B
Westampton, NJ 08060-5517

Mailing address

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

Other practice location 1

401 Young Ave Ste 325
Moorestown, NJ 08057-4800
Phone (856) 291-8865

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address scollazo226180@directvirtua.org
Direct Messaging Address scollazo226180@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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220823001778 NJ Practitioner - Obstetrics/Gynecology 6800279985 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
Cooper Medical School of Rowan University, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Virtua Medical Group, PAGroup PAC ID 9830222397, 1,678 clinicians

Practice addresses (Care Compare)

101 Burrs Rd
Suite Aandb
Westampton, NJ 08060-5517
Phone (609) 261-0240

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
81.15 of 100Reported as group
Quality
62.28
Promoting interoperability
100
Improvement activities
40
Cost
74.89

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of the uterus1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Virtua Medical Group, PA Current Accepting new patients
Virtua Medical Group, PA CurrentSince Sep 1, 2022 Accepting new patients
Virtua Medical Group, PA CurrentSince Sep 1, 2022 Accepting new patients
Virtua - Memorial Hospital Burlington County, Inc. Past Accepting new patients

Locations

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

141 Route 70 E
Ste E
Marlton, NJ 08053
Phone (856) 985-7373

301 Lippincott Dr
Ste 120
Marlton, NJ 08053
Phone (856) 355-0333

301 Lippincott Dr
Ste 410
Marlton, NJ 08053

303 Lippincott Dr
Marlton, NJ 08053

401 Young Ave
Ste 325
Moorestown, NJ 08057
Phone (800) 346-7834

101 Burrs Rd
Ste Ab
Westampton, NJ 08060
Phone (609) 261-0240

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

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": "1523232000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728000000000",
    "number": "1588161293",
    "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"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 BURRS RD STE A&B",
            "city": "WESTAMPTON",
            "state": "NJ",
            "postal_code": "080605517",
            "telephone_number": "609-261-0240"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "401 Young Ave Ste 325",
            "address_purpose": "LOCATION",
            "city": "Moorestown",
            "state": "NJ",
            "postal_code": "080574800",
            "country_code": "US",
            "telephone_number": "856-291-8865",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "COLLAZO",
        "first_name": "SAMANTHA",
        "middle_name": "ELLEN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-04-09",
        "last_updated": "2024-10-04",
        "certification_date": "2024-10-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "NJ",
            "license": "25MA11395800",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "scollazo226180@directvirtua.org",
            "affiliation": "N",
            "address_1": "101 Burrs Rd Ste A&b",
            "city": "Westampton",
            "state": "NJ",
            "country_code": "US",
            "postal_code": "080605517",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "scollazo226180@directvirtua.org",
            "affiliation": "N",
            "address_1": "401 Young Ave Ste 325",
            "city": "Moorestown",
            "state": "NJ",
            "country_code": "US",
            "postal_code": "080574800",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Westampton, NJ

Sources for this page

Verify at the official NPI Registry.