Individual provider Active NPI

Justin Sciancalepore, D.O.

  • Pulmonary Disease Physician
  • Stratford, NJ
National Provider Identifier
1659784072
Registry record updated Mar 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pulmonary Disease PhysicianTaxonomy code 207RP1001X
License
25MB09958400 Issued in NJ
Practice address
42 E Laurel Rd Ste 3100-a
Stratford, NJ 08084-1354
Phone
(856) 566-7070
Fax
(856) 566-7002
NPI assigned
Jun 3, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 15, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Pulmonary Disease Physician 207RP1001X 25MB09958400 NJ Primary
Internal Medicine Physician 207R00000X 25MB09958400 NJ

Addresses

Primary practice location

42 E Laurel Rd Ste 3100-a
Stratford, NJ 08084-1354

Mailing address

42 E Laurel Rd Ste 3100-a
Stratford, NJ 08084-1354
Phone (856) 566-7070

Other practice location 1

42 E Laurel Rd Ste 3100-D
Stratford, NJ 08084-1354
Phone (856) 566-7070

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address jsciancalepore253073@directvirtua.org
Direct Messaging Address jsciancalepore253073@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
I20200930000705 NJ Practitioner - Internal Medicine 4183043896 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Rowan University School of Osteopathic Medicine, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Virtua Medical Group, PAGroup PAC ID 9830222397, 1,678 clinicians

Practice addresses (Care Compare)

3242 Route 206
Bordentown, NJ 08505-4517

42 E Laurel Rd
Stratford, NJ 08084-1354

Hospital & facility affiliations

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
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
25MB09958400NJMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Virtua Medical Group, PA CurrentSince Jun 5, 2023 Accepting new patients
Virtua Medical Group, PA Internal Medicine CurrentSince Jun 4, 2023 Accepting new patients
Virtua Medical Group, PA CurrentSince Jun 5, 2023 Accepting new patients
Ccmma NJ LLC Pulmonary Disease CurrentSince Sep 8, 2020 Accepting new patients

Locations

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

100 Medical Center Way
Somers Point, NJ 08244
Phone (609) 272-0506

42 E Laurel Rd
Ste 3100
Stratford, NJ 08084
Phone (856) 566-2753

42 E Laurel Rd
Ste 3100D
Stratford, NJ 08084
Phone (856) 566-7070

42 E Laurel Rd
Ste 3100A
Stratford, NJ 08084
Phone (856) 566-7070

Interoperability endpoints

  • Direct secure messaging: jsciancalepore253073@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 and National Provider Directory roles.

Hospital & facility affiliations 2

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": "1401753600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710460800000",
    "number": "1659784072",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "42 E LAUREL RD STE 3100-A",
            "city": "STRATFORD",
            "state": "NJ",
            "postal_code": "080841354",
            "telephone_number": "856-566-7070",
            "fax_number": "856-566-7074"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "42 E LAUREL RD STE 3100-A",
            "city": "STRATFORD",
            "state": "NJ",
            "postal_code": "080841354",
            "telephone_number": "856-566-7070",
            "fax_number": "856-566-7002"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "42 E Laurel Rd Ste 3100-D",
            "address_purpose": "LOCATION",
            "city": "Stratford",
            "state": "NJ",
            "postal_code": "080841354",
            "country_code": "US",
            "telephone_number": "856-566-7070",
            "fax_number": "856-566-5079",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SCIANCALEPORE",
        "first_name": "JUSTIN",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-06-03",
        "last_updated": "2024-03-15",
        "certification_date": "2024-03-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "NJ",
            "license": "25MB09958400",
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NJ",
            "license": "25MB09958400",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jsciancalepore253073@directvirtua.org",
            "affiliation": "N",
            "address_1": "42 E Laurel Rd Ste 3100-D",
            "city": "Stratford",
            "state": "NJ",
            "country_code": "US",
            "postal_code": "080841354",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jsciancalepore253073@directvirtua.org",
            "affiliation": "N",
            "address_1": "42 E Laurel Rd Ste 3100-A",
            "city": "Stratford",
            "state": "NJ",
            "country_code": "US",
            "postal_code": "080841354",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Stratford, NJ

Sources for this page

Verify at the official NPI Registry.