Individual provider Active NPI

Nicole Mary Siems, D.O.

  • Obstetrics & Gynecology Physician
  • Egg Harbor Township, NJ
National Provider Identifier
1639404973
Registry record updated Sep 17, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
25MB09032600 Issued in NJ
Practice address
2500 English Creek Ave Ste 1000
Egg Harbor Township, NJ 08234-5508
Phone
(609) 677-7211
NPI assigned
Oct 5, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 17, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Obstetrics & Gynecology Physician 207V00000X 25MB09032600 NJ Primary

Addresses

Primary practice location

2500 English Creek Ave Ste 1000
Egg Harbor Township, NJ 08234-5508

Mailing address

2500 English Creek Ave Ste 1000
Egg Harbor Township, NJ 08234-5508

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120828000220 NJ Practitioner - Obstetrics/Gynecology 5991952830 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
New York College of Osteo Medicine of New York Institute of Technology, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Atlanticare Physician Group PAGroup PAC ID 8527953660, 506 clinicians

Practice addresses (Care Compare)

219 N White Horse Pike
104 Apg Bariatrics
Hammonton, NJ 08037-1800
Phone (609) 407-2332

459 Route 9 S
Little Egg Harbor TWP, NJ 08087-2225
Phone (609) 340-7815

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Southern Jersey Family Medical Centers, Inc CurrentSince Jul 9, 2020 Accepting new patients
Atlanticare Physician Group PA Obstetrics & Gynecology CurrentSince Dec 8, 2019 Accepting new patients
Atlanticare Physician Group, PA CurrentSince Dec 8, 2019 Accepting new patients
Atlanticare Regional Medical Center Past Accepting new patients

Locations

1125 Atlantic Ave
Atlantic City, NJ 08401
Phone (609) 348-0066

2500 English Creek Ave
Ste 1000
Egg Harbor Twp, NJ 08234
Phone (609) 383-6400

6550 Delilah Rd
Ste 301
Egg Hbr Twp, NJ 08234
Phone (609) 573-1251

860 S White Horse Pike
Hammonton, NJ 08037
Phone (609) 567-0200

459 Route 9 S
Little Egg Harbor Twp, NJ 08087
Phone (609) 340-7815

65 W Jimmie Leeds Rd
Pomona, NJ 08240
Phone (609) 484-6414

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 and National Provider Directory roles.

Hospital & facility affiliations 1

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": "1254700800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1600300800000",
    "number": "1639404973",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2500 ENGLISH CREEK AVE STE 1000",
            "city": "EGG HARBOR TOWNSHIP",
            "state": "NJ",
            "postal_code": "082345508"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2500 ENGLISH CREEK AVE STE 1000",
            "city": "EGG HARBOR TOWNSHIP",
            "state": "NJ",
            "postal_code": "082345508",
            "telephone_number": "609-677-7211"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIEMS",
        "first_name": "NICOLE",
        "middle_name": "MARY",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-10-05",
        "last_updated": "2020-09-17",
        "certification_date": "2020-09-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "NJ",
            "license": "25MB09032600",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Egg Harbor Township, NJ

Sources for this page

Verify at the official NPI Registry.