Individual provider Active NPI

Joanna Matos, APRN

  • Primary Care Nurse Practitioner
  • Marlton, NJ
National Provider Identifier
1679030639
Registry record updated Sep 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Nurse PractitionerTaxonomy code 363LP2300X
License
26NJ00900100 Issued in NJ
Practice address
765 Route 70 E Ste D-125
Marlton, NJ 08053-2341
Phone
(856) 453-4894
Fax
(856) 451-7248
NPI assigned
Feb 26, 2019
Last updated
Sep 9, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 9, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 26NJ00900100 NJ
Primary Care Nurse Practitioner 363LP2300X 26NJ00900100 NJ Primary

Addresses

Primary practice location

765 Route 70 E Ste D-125
Marlton, NJ 08053-2341

Mailing address

4 Mary Ellen LN
Erial, NJ 08081-9744
Phone (610) 203-2033

Other practice location 1

225 Wilmington W Chester Pike
Chadds Ford, PA 19317-9011
Phone (833) 728-1368

Other practice location 2

4 Mary Ellen Ln
Sicklerville, NJ 08081-9744
Phone (610) 203-2033

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ, DE, PA3 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

Enrollment IDStateProvider typePAC IDDetails
I20200929000594 NJ Practitioner - Nurse Practitioner 2567881386 Reassigns benefits to 3 organizations
I20240910002779 DE Practitioner - Nurse Practitioner 2567881386 Reassigns benefits to 1 organization
I20250904001934 PA Practitioner - Nurse Practitioner 2567881386 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1 Gateway Ctr
Suite 2600
Newark, NJ 07102-5323
Phone (833) 728-1368

132 E Delaware Ave
Suite 100
Newark, DE 19711-4643
Phone (833) 728-1368

225 Wilmington W Chester Pike
Chadds Ford, PA 19317-9011
Phone (833) 728-1368

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Nurse Practitioner Professional Resources CurrentSince Dec 20, 2021 Accepting new patients
Patient Sortal Health PLLC CurrentSince Jun 1, 2024 Accepting new patients
Patient Care Medical Group PC CurrentSince Sep 26, 2023 Accepting new patients

Locations

26 Main St
Edison, NJ 08837
Phone (609) 385-2622

1 Gateway Ctr
Ste 2600
Newark, NJ 07102
Phone (267) 999-9534

225 Wilmington W Chester Pike
Chadds Ford, PA 19317
Phone (833) 728-1368

225 Wilmington W Chester Pike
#P
Chadds Ford, PA 19317
Phone (833) 728-1368

3201 Dallas Pkwy
Ste 200
Frisco, TX 75034
Phone (469) 955-4041

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/26288/brand/1/csg/1/fhir/r4

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1551139200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1725840000000",
    "number": "1679030639",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4 MARY ELLEN LN",
            "city": "ERIAL",
            "state": "NJ",
            "postal_code": "080819744",
            "telephone_number": "610-203-2033",
            "fax_number": "520-363-6065"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "765 ROUTE 70 E STE D-125",
            "city": "MARLTON",
            "state": "NJ",
            "postal_code": "080532341",
            "telephone_number": "856-453-4894",
            "fax_number": "856-451-7248"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "225 Wilmington W Chester Pike",
            "address_purpose": "LOCATION",
            "city": "Chadds Ford",
            "state": "PA",
            "postal_code": "193179011",
            "country_code": "US",
            "telephone_number": "833-728-1368",
            "fax_number": "610-424-7537",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4 Mary Ellen Ln",
            "address_purpose": "LOCATION",
            "city": "Sicklerville",
            "state": "NJ",
            "postal_code": "080819744",
            "country_code": "US",
            "telephone_number": "610-203-2033",
            "fax_number": "520-363-6065",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MATOS",
        "first_name": "JOANNA",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-02-26",
        "last_updated": "2024-09-09",
        "certification_date": "2024-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NJ",
            "license": "26NJ00900100",
            "primary": false
        },
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "NJ",
            "license": "26NJ00900100",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Marlton, NJ

Sources for this page

Verify at the official NPI Registry.