Individual provider Active NPI

Marie Hegeman, PA

  • Physician Assistant
  • Voorhees, NJ
National Provider Identifier
1639315450
Registry record updated Dec 29, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
25MP00209300 Issued in NJ
Practice address
101 Carnie Blvd
Voorhees, NJ 08043-1548
Phone
(856) 686-4306
NPI assigned
Dec 29, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 29, 2008

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 25MP00209300 NJ Primary

Addresses

Primary practice location

101 Carnie Blvd
Voorhees, NJ 08043-1548

Mailing address

307 S Evergreen Ave
Woodbury, NJ 08096-2739

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
I20081222000587 NJ Practitioner - Physician Assistant 5799847968 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Drexel University College of Medicine, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
DRX Paramus, LLCGroup PAC ID 2466589585, 63 clinicians

Practice addresses (Care Compare)

1210 Route 130 N
Cinnaminson, NJ 08077-3046
Phone (856) 829-0407

165 S Black Horse Pike
Afc Urgent Care Paramus
Williamstown, NJ 08094-1559
Phone (856) 516-4700

2001 College Dr
Suite 11
Clementon, NJ 08021-5617
Phone (856) 566-3333

4318 Route 130
Willingboro, NJ 08046-1427
Phone (609) 871-2045

67 E Ridgewood Ave
Unit C
Paramus, NJ 07652-3623
Phone (201) 262-2010

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
25MP00209300NJMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Atlantic Professional Services of New Jersey, P.a. Physician Assistant Past Accepting new patients

Organizations & group practices 3

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": "1230508800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1230508800000",
    "number": "1639315450",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "307 S EVERGREEN AVE",
            "city": "WOODBURY",
            "state": "NJ",
            "postal_code": "080962739"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 CARNIE BLVD",
            "city": "VOORHEES",
            "state": "NJ",
            "postal_code": "080431548",
            "telephone_number": "856-686-4306"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HEGEMAN",
        "first_name": "MARIE",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-12-29",
        "last_updated": "2008-12-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NJ",
            "license": "25MP00209300",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Voorhees, NJ

Sources for this page

Verify at the official NPI Registry.