Individual provider Active NPI

Heather Stang, PA

  • Physician Assistant
  • Berlin, NJ
National Provider Identifier
1710455605
Registry record updated Jan 7, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
25MP00499000 Issued in NJ
Practice address
175 Cross Keys Rd Ste 300a
Berlin, NJ 08009-9263
Phone
(856) 767-0077
Fax
(856) 767-6102
NPI assigned
Nov 8, 2018
Last updated
Jan 7, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 7, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA222088 OR
Physician Assistant 363A00000X 25MP00499000 NJ Primary

Addresses

Primary practice location

175 Cross Keys Rd Ste 300a
Berlin, NJ 08009-9263

Mailing address

175 Cross Keys Rd Ste 300a
Berlin, NJ 08009-9263
Phone (856) 767-0077

Other practice location 1

1110 SE Alder St Ste 301
Portland, OR 97214-2400
Phone (503) 563-2742

Medicare participation

Medicare enrollment files
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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20181214002390 NJ Practitioner - Physician Assistant 1850636119 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
DRX Paramus, LLCGroup PAC ID 2466589585, 63 clinicians

Practice addresses (Care Compare)

1210 Route 130 N
Cinnaminson, NJ 08077-3046
Phone (856) 829-0407

1410 Delsea Dr
FL 2
Deptford, NJ 08096-4101
Phone (856) 579-8897

2 S Black Horse Pike
Mount Ephraim, NJ 08059-1321
Phone (856) 931-3107

2001 College Dr
Suite 11
Clementon, NJ 08021-5617
Phone (856) 566-3333

4318 Route 130
Willingboro, NJ 08046-1427
Phone (609) 871-2045

67 E Ridgewood Ave
Unit C
Paramus, NJ 07652-3623
Phone (201) 262-2010

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
25MP00499000NJMDPhysician Assistant
PA222088ORMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Advocare, LLC CurrentSince Oct 27, 2018 Accepting new patients
Advocare , LLC CurrentSince Oct 27, 2018 Accepting new patients
Jersey Irish Medical PastSince Oct 26, 2019 Accepting new patients
Advocare, LLC Past Accepting new patients

Locations

169 Mine Brook Rd
#P
Bernardsville, NJ 07924
Phone (908) 766-0034

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

402 Lippincott Dr
Marlton, NJ 08053
Phone (410) 763-8787

Interoperability endpoints

  • Direct secure messaging: heather.stang@advocaredoctors.eclinicaldirectplus.com

Organizations & group practices 5

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": "1541635200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736208000000",
    "number": "1710455605",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "175 CROSS KEYS RD STE 300A",
            "city": "BERLIN",
            "state": "NJ",
            "postal_code": "080099263",
            "telephone_number": "856-767-0077",
            "fax_number": "856-767-6102"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "175 CROSS KEYS RD STE 300A",
            "city": "BERLIN",
            "state": "NJ",
            "postal_code": "080099263",
            "telephone_number": "856-767-0077",
            "fax_number": "856-767-6102"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1110 SE Alder St Ste 301",
            "address_purpose": "LOCATION",
            "city": "Portland",
            "state": "OR",
            "postal_code": "972142400",
            "country_code": "US",
            "telephone_number": "503-563-2742",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "STANG",
        "first_name": "HEATHER",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-11-08",
        "last_updated": "2025-01-07",
        "certification_date": "2025-01-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OR",
            "license": "PA222088",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NJ",
            "license": "25MP00499000",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Berlin, NJ

Sources for this page

Verify at the official NPI Registry.