Individual provider Active NPI

Samantha Disantis, APN

  • Family Nurse Practitioner
  • Mullica Hill, NJ
National Provider Identifier
1629448493
Registry record updated Nov 13, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
26NJ00595500 Issued in NJ
Practice address
141 Bridgeton Pike Unit B
Mullica Hill, NJ 08062-2615
Phone
(856) 291-8600
Fax
(856) 291-8610
NPI assigned
Oct 5, 2015
Last updated
Nov 13, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 13, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 26NJ00595500 NJ Primary
Registered Nurse 163W00000X 26NR1252700 NJ

Addresses

Primary practice location

141 Bridgeton Pike Unit B
Mullica Hill, NJ 08062-2615

Mailing address

PO Box 7776
Lancaster, PA 17601
Phone (888) 985-2727

Other practice location 1

602 WCuthbert Blvd Unit 26 Ste A
Westmont, NJ 08108
Phone (856) 946-5180

Other practice location 2

239 Hurffville Crosskeys Rd Ste 160
Sewell, NJ 08080-4005
Phone (856) 341-8200

Other practice location 3

158 Route 73 Ste B
Voorhees, NJ 08043-9539
Phone (856) 247-7230

Other practice location 4

315 Route 70 E Ste A
Cherry Hill, NJ 08034-2408
Phone (856) 375-6240

Other practice location 5

128 Route 70 Ste 1
Medford, NJ 08055-2371
Phone (609) 367-0900

Other practice location 6

217 Capital Dr
Mantua, NJ 08051-1203
Phone (856) 217-1778

Other practice location 7

555 High St Ste 16A
Mount Holly, NJ 08060-1084
Phone (609) 444-5610

Other practice location 8

401 Young Ave Ste 180 Front
Moorestown, NJ 08057-3139
Phone (856) 291-8600

Other identifiers 1

IdentifierTypeStateIssuer
0550566MedicaidNJ

Electronic endpoints 8

TypeEndpointUseAffiliation
CONNECT URL LIFE Health Information Exchange (HIE)
Direct Messaging Address switt13990@directvirtua.org
Direct Messaging Address switt13990@directvirtua.org
Direct Messaging Address switt13990@directvirtua.org
Direct Messaging Address switt13990@directvirtua.org
Direct Messaging Address switt13990@directvirtua.org
Direct Messaging Address switt13990@directvirtua.org
Direct Messaging Address switt13990@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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160924000245 NJ Practitioner - Nurse Practitioner 6103113741 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2015
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)

141 Bridgeton Pike
Unit B
Mullica Hill, NJ 08062-2615
Phone (856) 746-0206

239 Hurffville Crosskeys Rd
Sewell, NJ 08080-4002

3242 Route 206
Bordentown, NJ 08505-4517

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

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
26NR1252700NJMDRegistered Nurse
26NJ00595500NJMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Virtua Medical Group, PA Current Accepting new patients
Virtua Medical Group, PA CurrentSince Jul 24, 2016 Accepting new patients
Virtua Medical Group, PA CurrentSince Jul 24, 2016 Accepting new patients
Advanced Spine and Pain, LLC PastSince Feb 12, 2023 Accepting new patients

Locations

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

315 Route 70 E
Ste A
Cherry Hill, NJ 08034
Phone (856) 375-6240

602 W Cuthbert Blvd
Unit 26
Haddon Township, NJ 08108
Phone (856) 946-5180

128 Route 70
Ste 1
Medford, NJ 08055
Phone (609) 367-0900

401 Young Ave
Ste 180
Moorestown, NJ 08057
Phone (856) 291-8600

555 High St
Ste 16A
Mount Holly, NJ 08060
Phone (609) 444-5610

141 Bridgeton Pike
Unit B
Mullica Hill, NJ 08062
Phone (856) 746-0206

239 Hurffville Crosskeys Rd
Ste 160
Sewell, NJ 08080
Phone (856) 341-8200

158 Route 73
#B
Voorhees, NJ 08043
Phone (856) 247-7230

Interoperability endpoints

  • Direct secure messaging: switt13990@directvirtua.org

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.

NPI Registry JSON

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

{
    "created_epoch": "1444003200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731456000000",
    "number": "1629448493",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 7776",
            "city": "LANCASTER",
            "state": "PA",
            "postal_code": "17601",
            "telephone_number": "888-985-2727",
            "fax_number": "856-779-0211"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "141 BRIDGETON PIKE UNIT B",
            "city": "MULLICA HILL",
            "state": "NJ",
            "postal_code": "080622615",
            "telephone_number": "856-291-8600",
            "fax_number": "856-291-8610"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "602 WCuthbert Blvd Unit 26 Ste A",
            "address_purpose": "LOCATION",
            "city": "Westmont",
            "state": "NJ",
            "postal_code": "08108",
            "country_code": "US",
            "telephone_number": "856-946-5180",
            "fax_number": "856-946-5181",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "239 Hurffville Crosskeys Rd Ste 160",
            "address_purpose": "LOCATION",
            "city": "Sewell",
            "state": "NJ",
            "postal_code": "080804005",
            "country_code": "US",
            "telephone_number": "856-341-8200",
            "fax_number": "856-341-8215",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "158 Route 73 Ste B",
            "address_purpose": "LOCATION",
            "city": "Voorhees",
            "state": "NJ",
            "postal_code": "080439539",
            "country_code": "US",
            "telephone_number": "856-247-7230",
            "fax_number": "856-247-7231",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "315 Route 70 E Ste A",
            "address_purpose": "LOCATION",
            "city": "Cherry Hill",
            "state": "NJ",
            "postal_code": "080342408",
            "country_code": "US",
            "telephone_number": "856-375-6240",
            "fax_number": "856-375-6241",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "128 Route 70 Ste 1",
            "address_purpose": "LOCATION",
            "city": "Medford",
            "state": "NJ",
            "postal_code": "080552371",
            "country_code": "US",
            "telephone_number": "609-367-0900",
            "fax_number": "609-367-0901",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "217 Capital Dr",
            "address_purpose": "LOCATION",
            "city": "Mantua",
            "state": "NJ",
            "postal_code": "080511203",
            "country_code": "US",
            "telephone_number": "856-217-1778",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "555 High St Ste 16A",
            "address_purpose": "LOCATION",
            "city": "Mount Holly",
            "state": "NJ",
            "postal_code": "080601084",
            "country_code": "US",
            "telephone_number": "609-444-5610",
            "fax_number": "609-444-5611",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "401 Young Ave Ste 180 Front",
            "address_purpose": "LOCATION",
            "city": "Moorestown",
            "state": "NJ",
            "postal_code": "080573139",
            "country_code": "US",
            "telephone_number": "856-291-8600",
            "fax_number": "856-291-8610",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DISANTIS",
        "first_name": "SAMANTHA",
        "name_prefix": "Miss",
        "credential": "APN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-10-05",
        "last_updated": "2024-11-13",
        "certification_date": "2024-11-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NJ",
            "license": "26NJ00595500",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NJ",
            "license": "26NR1252700",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0550566",
            "state": "NJ"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "LIFE",
            "affiliation": "N",
            "endpointDescription": "Work",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "2445 S Delsea Dr",
            "city": "Vineland",
            "state": "NJ",
            "country_code": "US",
            "postal_code": "083607000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "switt13990@directvirtua.org",
            "affiliation": "N",
            "address_1": "602 WCuthbert Blvd Unit 26 Ste A",
            "city": "Westmont",
            "state": "NJ",
            "country_code": "US",
            "postal_code": "08108",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "switt13990@directvirtua.org",
            "affiliation": "N",
            "address_1": "315 Route 70 E Ste A",
            "city": "Cherry Hill",
            "state": "NJ",
            "country_code": "US",
            "postal_code": "080342408",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "switt13990@directvirtua.org",
            "affiliation": "N",
            "address_1": "128 Route 70 Ste 1",
            "city": "Medford",
            "state": "NJ",
            "country_code": "US",
            "postal_code": "080552371",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "switt13990@directvirtua.org",
            "affiliation": "N",
            "address_1": "555 High St Ste 16A",
            "city": "Mount Holly",
            "state": "NJ",
            "country_code": "US",
            "postal_code": "080601084",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "switt13990@directvirtua.org",
            "affiliation": "N",
            "address_1": "239 Hurffville Crosskeys Rd Ste 160",
            "city": "Sewell",
            "state": "NJ",
            "country_code": "US",
            "postal_code": "080804005",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "switt13990@directvirtua.org",
            "affiliation": "N",
            "address_1": "158 Route 73 Ste B",
            "city": "Voorhees",
            "state": "NJ",
            "country_code": "US",
            "postal_code": "080439539",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "switt13990@directvirtua.org",
            "affiliation": "N",
            "address_1": "401 Young Ave Ste 180 Front",
            "city": "Moorestown",
            "state": "NJ",
            "country_code": "US",
            "postal_code": "080573139",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Mullica Hill, NJ

Sources for this page

Verify at the official NPI Registry.