Angel L Baillie, PHYSICIAN ASSISTANT

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

25MP00700100 Issued in NJ

Practice address

501 Fellowship Rd Ste 101
Mount Laurel, NJ 08054-3419

Phone

(856) 642-2133

NPI assigned

Mar 28, 2021

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in PA, MD, NJ3 enrollments

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 3

Specialty

Physician Assistant

Education

Other, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

CMC Department of Medicine Group PAGroup PAC ID 2163335878, 474 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Cooper University Hospital Hospital, Camden, NJ, CCN 310014

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: abaillie193420@direct.cooperhealth.edu

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.

• CMC Department of Medicine Group PA

  • Cardiovascular Disease Physician
  • Camden, NJ
  • NPI 1609908094
  Medicare reassignment Care Compare group NPD
• Jefferson University Physicians

  • General Practice Physician
  • Philadelphia, PA
  • NPI 1326093675
  Medicare reassignment NPD
• CMC Department of Medicine Group PA

  • Specialist
  • Camden, NJ
  • NPI 1386682094
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• The Cooper Health System

  • Land Ambulance
  • Camden, NJ
  • NPI 1174976724

  Hospital

  Care Compare affiliation
• The Cooper Health System

  • General Acute Care Hospital
  • Camden, NJ
  • NPI 1568442309
  Care Compare affiliation

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

{
    "created_epoch": "1616889600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1734912000000",
    "number": "1669059242",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 FEDERAL ST STE 200",
            "city": "CAMDEN",
            "state": "NJ",
            "postal_code": "081031088",
            "telephone_number": "848-288-6935",
            "fax_number": "732-790-0107"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "501 FELLOWSHIP RD STE 101",
            "city": "MOUNT LAUREL",
            "state": "NJ",
            "postal_code": "080543419",
            "telephone_number": "856-642-2133"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "111 S 11th St",
            "address_purpose": "LOCATION",
            "city": "Philadelphia",
            "state": "PA",
            "postal_code": "191074870",
            "country_code": "US",
            "telephone_number": "215-857-5697",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BAILLIE",
        "first_name": "ANGEL",
        "middle_name": "L",
        "credential": "PHYSICIAN ASSISTANT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-03-28",
        "last_updated": "2024-12-23",
        "certification_date": "2024-12-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "PA",
            "license": "MA063255",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NJ",
            "license": "25MP00700100",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Avalon Medical, LLC
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• Iman M Badawy, PHARM.D.
• Andrea Bader, BCBA
• Madeline Bakely
• Bancroft Neurohealth
• Bancroft Neurohealth
• Bancroft Neurohealth
• Bancroft Rehabilitation Services

• Physician Assistant in Mount Laurel, NJ
• Providers in Mount Laurel, NJ by specialty
• Physician Assistant in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 23, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.