Individual provider Active NPI

Alissa Brotman-O'Neill, D.O.

  • Vascular Surgery Physician
  • Stratford, NJ
National Provider Identifier
1649438540
Registry record updated Dec 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular Surgery PhysicianTaxonomy code 2086S0129X
License
25MBO8180500 Issued in NJ
Practice address
42 E Laurel Rd Ste 1300-a
Stratford, NJ 08084-1354
Phone
(856) 566-2710
Fax
(856) 256-5772
NPI assigned
May 28, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 3, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Vascular Surgery Physician 2086S0129X 25MBO8180500 NJ Primary
Surgery Physician 208600000X 25MBO8180500 NJ

Addresses

Primary practice location

42 E Laurel Rd Ste 1300-a
Stratford, NJ 08084-1354

Mailing address

42 E Laurel Rd Ste 1300-a
Stratford, NJ 08084-1354
Phone (856) 566-2710

Other practice location 1

100 Century Pkwy Ste 140A
Mount Laurel, NJ 08054-1149
Phone (856) 566-2710

Other names 1

  • Dr. Alissa Oneill Professional name

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address aoneill213552@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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100108000198 NJ Practitioner - Vascular Surgery 3274674536 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Vascular Surgery
Education
Rowan University School of Osteopathic Medicine, 2002
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)

100 Century Pkwy
Mount Laurel, NJ 08054-1149

3242 Route 206
Bordentown, NJ 08505-4517

42 E Laurel Rd
Stratford, NJ 08084-1354

Hospital & facility affiliations

  • West Jersey Hospital Hospital, Voorhees, NJ, CCN 310022

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

Procedures performed for Medicare patients

ProcedureNumber of procedures
Varicose vein removal13

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
25MBO8180500NJMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Virtua Medical Group, PA Surgery CurrentSince Jun 5, 2023 Accepting new patients
Virtua Medical Group, PA CurrentSince Jun 5, 2023 Accepting new patients
Charles L. Dietzek Vascular Surgery Past Accepting new patients
Charles L Dietzek, DO, Facos, PC Vascular Surgery PastSince Dec 26, 2017 Accepting new patients

Locations

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

100 Century Pkwy
Ste 140A
Mount Laurel, NJ 08054
Phone (856) 566-2710

Interoperability endpoints

  • Direct secure messaging: aoneill213552@directvirtua.org
  • Direct secure messaging: abrotmanoneill425010@direct.ahsys.org

Organizations & group practices 5

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": "1211932800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733184000000",
    "number": "1649438540",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "42 E LAUREL RD STE 1300-A",
            "city": "STRATFORD",
            "state": "NJ",
            "postal_code": "080841354",
            "telephone_number": "856-566-2710",
            "fax_number": "856-256-5772"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "42 E LAUREL RD STE 1300-A",
            "city": "STRATFORD",
            "state": "NJ",
            "postal_code": "080841354",
            "telephone_number": "856-566-2710",
            "fax_number": "856-256-5772"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "100 Century Pkwy Ste 140A",
            "address_purpose": "LOCATION",
            "city": "Mount Laurel",
            "state": "NJ",
            "postal_code": "080541149",
            "country_code": "US",
            "telephone_number": "856-566-2710",
            "fax_number": "856-566-2755",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BROTMAN-O'NEILL",
        "first_name": "ALISSA",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-05-28",
        "last_updated": "2024-12-03",
        "certification_date": "2024-12-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "NJ",
            "license": "25MBO8180500",
            "primary": true
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "NJ",
            "license": "25MBO8180500",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "aoneill213552@directvirtua.org",
            "affiliation": "N",
            "address_1": "42 E Laurel Rd Ste 1300-A",
            "city": "Stratford",
            "state": "NJ",
            "country_code": "US",
            "postal_code": "080841354",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "ALISSA",
            "last_name": "ONEILL",
            "prefix": "DR.",
            "credential": "DO",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Stratford, NJ

Sources for this page

Verify at the official NPI Registry.