Square One Health Services LLC

Primary specialty

Adult Health Nurse PractitionerTaxonomy code 363LA2200X

Legal business name

SQUARE ONE HEALTH SERVICES LLC

Practice address

199 6TH Ave # B-2
Mount Laurel, NJ 08054-9749

Phone

(856) 938-8642

NPI assigned

Apr 30, 2021

Last updated

Apr 30, 2021By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Matthew Kaspar, APNNPI 1588948244

Title

Nurse Practitioner/Partner

Phone

(856) 938-8643

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NJ

Enrollment records 1

Locations

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Matthew Kaspar, APN

  • Family Nurse Practitioner
  • Mount Holly, NJ
  • NPI 1588948244
  Medicare reassignment Care Compare group Authorized official
• Tessandra Gulbranson

  • Family Nurse Practitioner
  • Cherry Hill, NJ
  • NPI 1891166849
  Medicare reassignment Care Compare group
• Amy Corris

  • Student in an Organized Health Care Education/Training Program
  • Mount Laurel, NJ
  • NPI 1164280483
  NPD
• Emily Earley

  • Peer Specialist
  • Voorhees, NJ
  • NPI 1023974128
  NPD
• Cabrina Leigh Hernandez, LPN

  • Licensed Practical Nurse
  • Mount Laurel, NJ
  • NPI 1396493359
  NPD
• Joy Tomassetti, LPN

  • Registered Nurse
  • Mount Laurel, NJ
  • NPI 1508601998
  NPD
• Tariq S. Siddiqi, M.D.

  • Neurological Surgery Physician
  • Voorhees, NJ
  • NPI 1861431942
  NPD (past)

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

{
    "created_epoch": "1619740800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1619740800000",
    "number": "1588247233",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6 TAISLEY CT",
            "city": "MEDFORD",
            "state": "NJ",
            "postal_code": "080553207",
            "telephone_number": "856-938-8642"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "199 6TH AVE # B-2",
            "city": "MOUNT LAUREL",
            "state": "NJ",
            "postal_code": "080549749",
            "telephone_number": "856-938-8642"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SQUARE ONE HEALTH SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-04-30",
        "last_updated": "2021-04-30",
        "certification_date": "2021-04-30",
        "status": "A",
        "authorized_official_last_name": "KASPAR",
        "authorized_official_first_name": "MATTHEW",
        "authorized_official_title_or_position": "NURSE PRACTITIONER/PARTNER",
        "authorized_official_telephone_number": "856-938-8643",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "APN"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Adult Health Nurse Practitioner in Mount Laurel, NJ
• Providers in Mount Laurel, NJ by specialty
• Adult Health Nurse Practitioner in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 30, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.