NPIMap

Individual provider Active NPI

Jennifer Naticchia, MD

  • Family Medicine Physician
  • Haddonfield, NJ
National Provider Identifier
1588635296
Registry record updated Apr 5, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
25MA06243900 Issued in NJ
Practice address
80 Tanner St
Haddonfield, NJ 08033-2453
Phone
(844) 542-2273
NPI assigned
Jan 30, 2006
Last updated
Apr 5, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 5, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 25MA06243900 NJ Primary

Addresses

Primary practice location

80 Tanner St
Haddonfield, NJ 08033-2453

Mailing address

401 Route 73 N
40 Lake Center Drive Suite 201a
Marlton, NJ 08053-3425
Phone (856) 355-0340

Other practice location 1

80 Tanner St
Haddonfield, NJ 08033-2453
Phone (844) 542-2273

Other identifiers 1

IdentifierTypeStateIssuer
7258208MedicaidNJ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100203000553 NJ Practitioner - Family Practice 9830155126 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Jefferson Medical College of Thomas Jefferson University, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Inspira Health Network Medical Group PCGroup PAC ID 4880797570, 238 clinicians

Practice addresses (Care Compare)

485 Williamstown Rd
Sicklerville, NJ 08081-1777
Phone (856) 237-8100

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
25MA06243900NJMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Virtua Medical Group, PA CurrentSince Jul 1, 2010 Accepting new patients
Inspira Health Network Medical Group, P.C. CurrentSince Sep 25, 2020 Accepting new patients
Virtua Surgical Group, P.a Past Accepting new patients

Locations

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

1120 Delsea Dr N
Glassboro, NJ 08028
Phone (856) 205-7071

1238 Chews Landing Rd
Laurel Springs, NJ 08021
Phone (856) 545-9500

798 Centerton Rd
Pittsgrove, NJ 08318
Phone (856) 358-6161

485 Williamstown Rd
Sicklerville, NJ 08081
Phone (856) 237-8080

1 S White Horse Pike
Somerdale, NJ 08083
Phone (856) 545-9610

17 W Red Bank Ave
Ste 104
Woodbury, NJ 08096
Phone (856) 848-0665

509 N Broad St
Woodbury, NJ 08096
Phone (856) 686-5396

75 W Red Bank Ave
Woodbury, NJ 08096
Phone (856) 853-2055

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 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": "1138579200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1522886400000",
    "number": "1588635296",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "401 ROUTE 73 N",
            "address_2": "40 LAKE CENTER DRIVE SUITE 201A",
            "city": "MARLTON",
            "state": "NJ",
            "postal_code": "080533425",
            "telephone_number": "856-355-0340",
            "fax_number": "856-355-0346"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "80 TANNER ST",
            "city": "HADDONFIELD",
            "state": "NJ",
            "postal_code": "080332453",
            "telephone_number": "844-542-2273"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "80 Tanner St",
            "address_purpose": "LOCATION",
            "city": "Haddonfield",
            "state": "NJ",
            "postal_code": "080332453",
            "country_code": "US",
            "telephone_number": "844-542-2273",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NATICCHIA",
        "first_name": "JENNIFER",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-01-30",
        "last_updated": "2018-04-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NJ",
            "license": "25MA06243900",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7258208",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Haddonfield, NJ

Sources for this page

Verify at the official NPI Registry.