Individual provider Active NPI

Matthew Nagle, PA

  • Surgical Physician Assistant
  • Cherry Hill, NJ
National Provider Identifier
1720012206
Registry record updated Oct 28, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
25MP00039000 Issued in NJ
Practice address
1 Brace Rd Ste H
Cherry Hill, NJ 08034-2600
Phone
(856) 547-0389
NPI assigned
Jul 10, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 28, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 25MP00039000 NJ
Medical Physician Assistant 363AM0700X 25MP00039000 NJ
Surgical Physician Assistant 363AS0400X 25MP00039000 NJ Primary

Addresses

Primary practice location

1 Brace Rd Ste H
Cherry Hill, NJ 08034-2600

Mailing address

301 Lippincott Dr Ste 410
Marlton, NJ 08053-4197
Phone (856) 355-0340

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address mnagle102785@directvirtua.org

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
I20050902000116 NJ Practitioner - Physician Assistant 7810929676 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Virtua Medical Group, PAGroup PAC ID 9830222397, 1,678 clinicians

Practice addresses (Care Compare)

1600 Haddon Ave
Camden, NJ 08103-3101

3242 Route 206
Bordentown, NJ 08505-4517

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
81.15 of 100Reported as group
Quality
62.28
Promoting interoperability
100
Improvement activities
40
Cost
74.89

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
25MP00039000NJMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Virtua Medical Group, PA Physician Assistant CurrentSince Aug 1, 2020 Accepting new patients
Virtua Medical Group, PA CurrentSince Aug 1, 2020 Accepting new patients
Virtua Medical Group, PA Past Accepting new patients
Associates in Rehabilitation Medicine, PC Past Accepting new patients
Post-Acute Medical Associates, P.C. Past Accepting new patients
Practice Associates Medical Group PastSince Apr 22, 2012 Accepting new patients
Saint Michaels Physician Services PC PastSince Feb 23, 2013 Accepting new patients

Locations

3242 Route 206
Ste 2
Bordentown, NJ 08505
Phone (609) 298-4340

1 Brace Rd
Ste H
Cherry Hill, NJ 08034
Phone (856) 547-0389

1935 Route 70 E
Cherry Hill, NJ 08003
Phone (856) 246-3920

301 Lippincott Dr
Ste 410
Marlton, NJ 08053

Organizations & group practices 8

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

Hospital & facility affiliations 1

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

NPI Registry JSON

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

{
    "created_epoch": "1152489600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730073600000",
    "number": "1720012206",
    "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": "856-355-0340",
            "fax_number": "856-355-0340"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 BRACE RD STE H",
            "city": "CHERRY HILL",
            "state": "NJ",
            "postal_code": "080342600",
            "telephone_number": "856-547-0389"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NAGLE",
        "first_name": "MATTHEW",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-10",
        "last_updated": "2024-10-28",
        "certification_date": "2024-10-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NJ",
            "license": "25MP00039000",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NJ",
            "license": "25MP00039000",
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "NJ",
            "license": "25MP00039000",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mnagle102785@directvirtua.org",
            "affiliation": "N",
            "address_1": "1 Brace Rd Ste H",
            "city": "Cherry Hill",
            "state": "NJ",
            "country_code": "US",
            "postal_code": "080342600",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Cherry Hill, NJ

Sources for this page

Verify at the official NPI Registry.