Individual provider Active NPI

Kelsey Osowski

  • Physician Assistant
  • Voorhees, NJ
National Provider Identifier
1710511654
Registry record updated Dec 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
25MP00594000 Issued in NJ
Practice address
701 Cooper Rd Ste 16
Voorhees, NJ 08043-8007
Phone
(856) 429-2224
Fax
(856) 429-1926
NPI assigned
Mar 1, 2020
Last updated
Dec 16, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 16, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 25MP00594000 NJ Primary

Addresses

Primary practice location

701 Cooper Rd Ste 16
Voorhees, NJ 08043-8007

Mailing address

4170 City Ave
Philadelphia, PA 19131-1610
Phone (215) 871-6772

Other practice location 1

4170 City Ave
Philadelphia, PA 19131-1610
Phone (215) 871-6772

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
I20210909000013 NJ Practitioner - Physician Assistant 9638583768 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Robert J Maro MD PAGroup PAC ID 5193627826, 15 clinicians

Practice addresses (Care Compare)

701 Cooper Rd
Suite 16
Voorhees, NJ 08043-8007
Phone (856) 429-2224

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
25MP00594000NJMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Integrated Family Medicine, LLC CurrentSince Dec 22, 2024 Accepting new patients

Locations

701 Cooper Rd
Ste 16
Voorhees, NJ 08043
Phone (856) 429-2224

Organizations & group practices 2

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": "1583020800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1734307200000",
    "number": "1710511654",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4170 CITY AVE",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191311610",
            "telephone_number": "215-871-6772"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "701 COOPER RD STE 16",
            "city": "VOORHEES",
            "state": "NJ",
            "postal_code": "080438007",
            "telephone_number": "856-429-2224",
            "fax_number": "856-429-1926"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4170 City Ave",
            "address_purpose": "LOCATION",
            "city": "Philadelphia",
            "state": "PA",
            "postal_code": "191311610",
            "country_code": "US",
            "telephone_number": "215-871-6772",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "OSOWSKI",
        "first_name": "KELSEY",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-03-01",
        "last_updated": "2024-12-16",
        "certification_date": "2024-12-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NJ",
            "license": "25MP00594000",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Voorhees, NJ

Sources for this page

Verify at the official NPI Registry.