Dana Supe, MD

Primary specialty

Pulmonary Disease PhysicianTaxonomy code 207RP1001X

License

25MA06493000 Issued in NJ

Practice address

Renaissance Square, 141 Route 70, Suite B
Marlton, NJ 08053

Phone

(856) 596-9057

Fax

(856) 596-0837

NPI assigned

Jun 4, 2006

Last updated

Aug 26, 2024By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Other identifiers 1

Electronic endpoints 1

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: medrecs@deborah.medalliesdirect.net

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.

• Jersey Intensivist Associates LLC

  • Critical Care Medicine (Internal Medicine) Physician
  • Hamilton, NJ
  • NPI 1255776951
  Medicare reassignment NPD
• Professional Service Fund of Deborah Heart & Lung Center

  • Specialist
  • Browns Mills, NJ
  • NPI 1407803596
  Medicare reassignment NPD
• Route Intensivists Services LLC

  • Emergency Medicine Physician
  • Manahawkin, NJ
  • NPI 1447718531

  Critical Care Medicine

  Medicare reassignment NPD
• Rutgers Health-RWJ Scleroderma Program

  • Pulmonary Disease Physician
  • New Brunswick, NJ
  • NPI 1275563611
  Medicare reassignment NPD
• Virtua Medical Group, PA

  • Family Medicine Physician
  • Marlton, NJ
  • NPI 1649226515

  Internal Medicine

  Medicare reassignment NPD
• Deborah Heart and Lung Center

  • General Acute Care Hospital
  • Browns Mills, NJ
  • NPI 1467440743
  NPD
• Virtua Medical Group, PA

  dba Virtua Reconstructive Orthopedics - Delran

  • Orthopaedic Surgery Physician
  • Delran, NJ
  • NPI 1841087988
  NPD
• Digestive Disease Consultants PC

  • Gastroenterology Physician
  • Staten Island, NY
  • NPI 1548384332
  NPD (past)
• Mid Columbia Eyecare Center, Inc, PS

  • Optometrist
  • Pasco, WA
  • NPI 1750585972
  NPD (past)

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

{
    "created_epoch": "1149379200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724630400000",
    "number": "1679511208",
    "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": "856-596-9057",
            "fax_number": "856-596-0837"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "RENAISSANCE SQUARE, 141 ROUTE 70, SUITE B",
            "city": "MARLTON",
            "state": "NJ",
            "postal_code": "08053",
            "telephone_number": "856-596-9057",
            "fax_number": "856-596-0837"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "200 Trenton Rd",
            "address_2": "DEPT. OF SURGERY",
            "address_purpose": "LOCATION",
            "city": "Browns Mills",
            "state": "NJ",
            "postal_code": "080151705",
            "country_code": "US",
            "telephone_number": "609-893-1200 x4353",
            "fax_number": "609-735-0175",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SUPE",
        "first_name": "DANA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-04",
        "last_updated": "2024-08-26",
        "certification_date": "2024-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NJ",
            "license": "25MA06493000",
            "primary": false
        },
        {
            "code": "207RC0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": "NJ",
            "license": "25MA06493000",
            "primary": false
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "NJ",
            "license": "25MA06493000",
            "primary": true
        },
        {
            "code": "207RS0012X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Sleep Medicine",
            "state": "NJ",
            "license": "25MA06493000",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8780102",
            "state": "NJ"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "msupemd20740@directvirtua.org",
            "affiliation": "N",
            "address_1": "Renaissance Square, 141 Route 70, Suite B",
            "city": "Marlton",
            "state": "NJ",
            "country_code": "US",
            "postal_code": "08053",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Summit Surgical Center, LLC (Hand Surgery Center)
• Suncrest Hospice South Jersey LLC
• Neal David Sundberg, D.C.
• Elaine Sung, DPT
• Sunmed Medical Systems LLC
• Justin Adam Supnick
• Surgical PA Services, PC
• Surgical Specialists of New Jersey, LLC
• Jewelle R Sutherland, MD
• Tracey Swain, LCSW

• Pulmonary Disease Physician in Marlton, NJ
• Providers in Marlton, NJ by specialty
• Pulmonary Disease Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.