NPIMap

Organization Active NPI

Virtua Medical Group, PA

  • Orthopaedic Surgery Physician
  • Sewell, NJ
National Provider Identifier
1669156980
Registry record updated Jun 14, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
Legal business name
VIRTUA MEDICAL GROUP, PA
Practice address
570 Egg Harbor Rd Ste C4
Sewell, NJ 08080-2359
Phone
(856) 256-0051
Fax
(856) 270-2786
NPI assigned
Jun 15, 2023
Last updated
Jun 14, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 14, 2024

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

Authorized official

Name
John Mark Matsinger, DONPI 1700827292
Title
Evp; Chief Operating Officer
Phone
(856) 355-0340

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 7

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X
Physician Assistant 363A00000X
Surgical Physician Assistant 363AS0400X
Nurse Practitioner 363L00000X
Orthopaedic Surgery Physician 207X00000X Primary
Physical Medicine & Rehabilitation Physician 208100000X
Pain Medicine (Physical Medicine & Rehabilitation) Physician 2081P2900X

Addresses

Primary practice location

570 Egg Harbor Rd Ste C4
Sewell, NJ 08080-2359

Mailing address

301 Lippincott Dr Ste 410
Marlton, NJ 08053-4197
Phone (856) 355-0340

Other names 1

  • Virtua Reconstructive Orthopedics - Sewell Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20231106002494 NJ DME Supplier - Multi-Specialty - Physician 9830222397 Practice locations: Sewell, NJ

Other NPIs with the same Medicare PAC ID 12

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
31D2293377Virtua Reconstructive Orthopedics - Sewell570 Egg Harbor Road, Sewell, NJ 08080Certificate of waiverNov 7, 2027

National Provider Directory

National Provider Directory
Tax ID family
Virtua Medical Group PA20 organizations share this tax ID, including this one

Other organizations with this tax ID 19

Organizations that report the same tax identification number in the National Provider Directory.

View all 19

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1686787200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1718323200000",
    "number": "1669156980",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "301 LIPPINCOTT DR STE 410",
            "city": "MARLTON",
            "state": "NJ",
            "postal_code": "080534197",
            "telephone_number": "856-355-0340",
            "fax_number": "856-355-0330"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "570 EGG HARBOR RD STE C4",
            "city": "SEWELL",
            "state": "NJ",
            "postal_code": "080802359",
            "telephone_number": "856-256-0051",
            "fax_number": "856-270-2786"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VIRTUA MEDICAL GROUP, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-06-15",
        "last_updated": "2024-06-14",
        "certification_date": "2024-06-14",
        "status": "A",
        "authorized_official_last_name": "MATSINGER",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "MARK",
        "authorized_official_title_or_position": "EVP; CHIEF OPERATING OFFICER",
        "authorized_official_telephone_number": "856-355-0340",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2081P2900X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation, Pain Medicine",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Virtua Reconstructive Orthopedics - Sewell",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "Virtua Reconstructive Orthopedics - Sewell",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Sewell, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 14, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.