Individual provider Active NPI

Kristie Malloy, PA-C

  • Physician Assistant
  • Camden, NJ
National Provider Identifier
1609280031
Registry record updated Sep 24, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
25MP00943500 Issued in NJ
Practice address
1600 Haddon Ave
Camden, NJ 08103-3101
Phone
(856) 247-2160
Fax
(856) 247-2165
NPI assigned
Jun 13, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 24, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 25MP00943500 NJ Primary
Physician Assistant 363A00000X MA056898 PA
Medical Physician Assistant 363AM0700X MA056898 PA

Addresses

Primary practice location

1600 Haddon Ave
Camden, NJ 08103-3101

Mailing address

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

Other practice location 1

100 Bowman Dr Lowr Level2
Voorhees, NJ 08043-9612
Phone (856) 247-2160

Other practice location 2

90 Brick Rd Fl 3
Marlton, NJ 08053-2177
Phone (856) 247-2160

Other practice location 3

175 Madison Ave Fl 1
Mount Holly, NJ 08060-2099
Phone (609) 914-6000

Other identifiers 1

IdentifierTypeStateIssuer
103143340MedicaidPA

Electronic endpoints 4

TypeEndpointUseAffiliation
Direct Messaging Address kmalloy308003@directvirtua.org
Direct Messaging Address kmalloy308003@directvirtua.org
Direct Messaging Address kmalloy308003@directvirtua.org
Direct Messaging Address kmalloy308003@directvirtua.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA, NJ2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20140829002009 PA Practitioner - Physician Assistant 7911125109 Reassigns benefits to 5 organizations
I20250828000865 NJ Practitioner - Physician Assistant 7911125109 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Virtua Medical Group, PAGroup PAC ID 9830222397, 1,678 clinicians
University of Penn-Medical GroupGroup PAC ID 6204730955, shared by 15 NPIs, 3,433 clinicians

Practice addresses (Care Compare)

100 Bowman Dr
Voorhees, NJ 08043-9612
Phone (856) 247-7260

1600 Haddon Ave
Camden, NJ 08103-3101

175 Madison Ave
Mount Holly, NJ 08060-2038

3242 Route 206
Bordentown, NJ 08505-4517

3400 Spruce St
Philadelphia, PA 19104-4206

3400 Spruce Street 5 White BLDG
Oral and Maxillofacial Surgery Hup
Philadelphia, PA 19104-4206
Phone (215) 829-6079

90 Brick Rd
Marlton, NJ 08053-2177
Phone (856) 247-7260

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
84.91 of 100Reported as group
Quality
73.58
Promoting interoperability
100
Improvement activities
40
Cost
76.13

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
25MP00943500NJMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Pinnacle Health Medical Services CurrentSince Oct 1, 2015 Accepting new patients
Virtua Medical Group, PA CurrentSince Sep 1, 2025 Accepting new patients
University of Penn-Medical Group CurrentSince Mar 23, 2020 Accepting new patients
University of Penn-Medical Group CurrentSince Dec 4, 2017 Accepting new patients
Pinnacle Health Medical Services CurrentSince Oct 1, 2015 Accepting new patients
University of Penn-Medical Group CurrentSince Dec 4, 2017 Accepting new patients
Virtua Medical Group, PA Physician Assistant CurrentSince Sep 1, 2025 Accepting new patients
Virtua Medical Group, PA Past Accepting new patients

Locations

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

303 Lippincott Dr
Ste 200
Marlton, NJ 08053
Phone (856) 355-0335

90 Brick Rd
Fl 3
Marlton, NJ 08053
Phone (856) 247-2160

301 Lippincott Dr
Ste 410
Marlton, NJ 08053

175 Madison Ave
Fl 1
Mount Holly, NJ 08060
Phone (609) 914-6000

100 Bowman Dr
Lowr
Voorhees, NJ 08043
Phone (856) 247-3000

111 S Front St
Harrisburg, PA 17101
Phone (717) 782-3282

2501 N 3rd St
Fl 2
Harrisburg, PA 17110
Phone (717) 782-2100

409 S 2nd St
Ste 2F
Harrisburg, PA 17104
Phone (717) 231-8049

4300 Londonderry Rd
Lower Paxton, PA 17109
Phone (717) 597-7044

3624 Market St
Fl 2
Philadelphia, PA 19104
Phone (215) 615-3669

Organizations & group practices 13

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.

View all 13

Hospital & facility affiliations 5

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": "1402617600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1758672000000",
    "number": "1609280031",
    "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",
            "fax_number": "856-355-0330"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1600 HADDON AVE",
            "city": "CAMDEN",
            "state": "NJ",
            "postal_code": "081033101",
            "telephone_number": "856-247-2160",
            "fax_number": "856-247-2165"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "100 Bowman Dr Lowr Level2",
            "address_purpose": "LOCATION",
            "city": "Voorhees",
            "state": "NJ",
            "postal_code": "080439612",
            "country_code": "US",
            "telephone_number": "856-247-2160",
            "fax_number": "856-247-2165",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "90 Brick Rd Fl 3",
            "address_purpose": "LOCATION",
            "city": "Marlton",
            "state": "NJ",
            "postal_code": "080532177",
            "country_code": "US",
            "telephone_number": "856-247-2160",
            "fax_number": "856-247-2165",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "175 Madison Ave Fl 1",
            "address_purpose": "LOCATION",
            "city": "Mount Holly",
            "state": "NJ",
            "postal_code": "080602099",
            "country_code": "US",
            "telephone_number": "609-914-6000",
            "fax_number": "609-914-6182",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MALLOY",
        "first_name": "KRISTIE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-06-13",
        "last_updated": "2025-09-24",
        "certification_date": "2025-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NJ",
            "license": "25MP00943500",
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "PA",
            "license": "MA056898",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "PA",
            "license": "MA056898",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "103143340",
            "state": "PA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kmalloy308003@directvirtua.org",
            "affiliation": "N",
            "address_1": "175 Madison Ave Fl 1",
            "city": "Mount Holly",
            "state": "NJ",
            "country_code": "US",
            "postal_code": "080602099",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kmalloy308003@directvirtua.org",
            "affiliation": "N",
            "address_1": "1600 Haddon Ave",
            "city": "Camden",
            "state": "NJ",
            "country_code": "US",
            "postal_code": "081033101",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kmalloy308003@directvirtua.org",
            "affiliation": "N",
            "address_1": "100 Bowman Dr Lowr Level2",
            "city": "Voorhees",
            "state": "NJ",
            "country_code": "US",
            "postal_code": "080439612",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kmalloy308003@directvirtua.org",
            "affiliation": "N",
            "address_1": "90 Brick Rd Fl 3",
            "city": "Marlton",
            "state": "NJ",
            "country_code": "US",
            "postal_code": "080532177",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Camden, NJ

Sources for this page

Verify at the official NPI Registry.