NPIMap

Individual provider Active NPI

Tamara Marie Fisicaro, MD

  • Internal Medicine Physician
  • Blackwood, NJ
National Provider Identifier
1700094075
Registry record updated Mar 18, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
25MA08576700 Issued in NJ
Practice address
527 S. Black Horse Pike
Blackwood, NJ 08012
Phone
(856) 302-5322
Fax
(856) 245-7719
NPI assigned
May 19, 2007
Last updated
Mar 18, 2014By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 18, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 25MA08576700 NJ Primary

Addresses

Primary practice location

527 S. Black Horse Pike
Blackwood, NJ 08012

Mailing address

527 S. Black Horse Pike
Blackwood, NJ 08012
Phone (856) 302-5322

Other identifiers 1

IdentifierTypeStateIssuer
DA5946OtherRR MEDICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20091208000754 NJ Practitioner - Internal Medicine 8527107226 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Advocare, LLCGroup PAC ID 3678562188, 383 clinicians

Practice addresses (Care Compare)

527 S Black Horse Pke
Blackwood, NJ 08012-2868
Phone (856) 220-8106

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
25MA08576700NJMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Advocare, LLC Internal Medicine CurrentSince Aug 6, 2009 Accepting new patients
Advocare , LLC Internal Medicine CurrentSince Aug 6, 2009 Accepting new patients
Advocare, LLC Past Accepting new patients

Locations

527 S Black Horse Pike
Blackwood, NJ 08012
Phone (856) 228-1061

132 Grove St
Ste A
Haddonfield, NJ 08033
Phone (856) 354-2211

401 Route 73 N
Ste 320
Marlton, NJ 08053
Phone (609) 471-1033

Interoperability endpoints

  • Direct secure messaging: tamara.fisicaro@advocaredoctors.eclinicaldirectplus.com

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.

Hospital & facility affiliations 14

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

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1179532800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1395100800000",
    "number": "1700094075",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "527 S. BLACK HORSE PIKE",
            "city": "BLACKWOOD",
            "state": "NJ",
            "postal_code": "08012",
            "telephone_number": "856-302-5322",
            "fax_number": "856-245-7719"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "527 S. BLACK HORSE PIKE",
            "city": "BLACKWOOD",
            "state": "NJ",
            "postal_code": "08012",
            "telephone_number": "856-302-5322",
            "fax_number": "856-245-7719"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FISICARO",
        "first_name": "TAMARA",
        "middle_name": "MARIE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-19",
        "last_updated": "2014-03-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NJ",
            "license": "25MA08576700",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "DA5946",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Blackwood, NJ

Sources for this page

Verify at the official NPI Registry.