Individual provider Active NPI

Kimberly M Winiarczyk, PA

  • Physician Assistant
  • Moorestown, NJ
National Provider Identifier
1629454376
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
MA057672 Issued in PA
Practice address
401 Young Ave Ste 245
Moorestown, NJ 08057-3132
Phone
(609) 267-9400
Fax
(609) 267-9457
NPI assigned
Aug 5, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X MA057672 PA Primary

Addresses

Primary practice location

401 Young Ave Ste 245
Moorestown, NJ 08057-3132

Mailing address

4 Eves Dr Ste 100a
Marlton, NJ 08053-3195
Phone (609) 267-9400

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
I20151111001766 NJ Practitioner - Physician Assistant 7618283367 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

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
Physician Assistant

State licenses

LicenseStateTypeSpecialty
MA057672PAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Virtua Medical Group, PA CurrentSince Jul 19, 2023 Accepting new patients

Locations

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

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1438732800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1629454376",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4 EVES DR STE 100A",
            "city": "MARLTON",
            "state": "NJ",
            "postal_code": "080533195",
            "telephone_number": "609-267-9400",
            "fax_number": "609-267-9457"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 YOUNG AVE STE 245",
            "city": "MOORESTOWN",
            "state": "NJ",
            "postal_code": "080573132",
            "telephone_number": "609-267-9400",
            "fax_number": "609-267-9457"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WINIARCZYK",
        "first_name": "KIMBERLY",
        "middle_name": "M",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-08-05",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "PA",
            "license": "MA057672",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Moorestown, NJ

Sources for this page

Verify at the official NPI Registry.