NPIMap

Individual provider Active NPI

Leonard A Powell Jr., D. O.

  • Geriatric Medicine (Family Medicine) Physician
  • Stratford, NJ
National Provider Identifier
1750644928
Registry record updated Mar 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Geriatric Medicine (Family Medicine) PhysicianTaxonomy code 207QG0300X
License
25MB09553400 Issued in NJ
Practice address
42 E Laurel Rd Ste 1800
Stratford, NJ 08084-1338
Phone
(856) 566-6843
Fax
(856) 566-6419
NPI assigned
Jun 21, 2012
Last updated
Mar 15, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 15, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 25MB09553400 NJ
Geriatric Medicine (Family Medicine) Physician 207QG0300X 25MB09553400 NJ Primary

Addresses

Primary practice location

42 E Laurel Rd Ste 1800
Stratford, NJ 08084-1338

Mailing address

42 E Laurel Rd Ste 1800
Stratford, NJ 08084-1338
Phone (856) 566-6843

Other identifiers 1

IdentifierTypeStateIssuer
0480479MedicaidNJ

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address lpowell34984@directvirtua.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ, NY, VA, OH4 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 4

Enrollment IDStateProvider typePAC IDDetails
I20151009001100 NJ Practitioner - Family PracticePractitioner - Geriatric Medicine 6608184767 Reassigns benefits to 2 organizations
I20240115000847 NY Practitioner - Family PracticePractitioner - Geriatric Medicine 6608184767
I20240311003925 VA Practitioner - Family PracticePractitioner - Geriatric Medicine 6608184767
I20240411001113 OH Practitioner - Family PracticePractitioner - Geriatric Medicine 6608184767

Care Compare profile

Medicare Care Compare
Specialty
Family PracticeAlso: Geriatric Medicine
Education
Rowan University School of Osteopathic Medicine, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Virtua Medical Group, PAGroup PAC ID 9830222397, 1,678 clinicians

Practice addresses (Care Compare)

100 Bowman Dr
Voorhees, NJ 08043-9612
Phone (856) 247-7260

3242 Route 206
Bordentown, NJ 08505-4517

42 E Laurel Rd
Stratford, NJ 08084-1354

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
25MB09553400NJMDGeriatric Medicine (Family Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Virtua Medical Group, PA Family Medicine Current Accepting new patients
Virtua Medical Group, PA CurrentSince Jun 5, 2023 Accepting new patients
Rowansom New Jersey Institute for Successful Aging Family Medicine CurrentSince Jul 1, 2016 Accepting new patients
Rowansom Newjersey Institute for Successful Aging-Geriatric Psychiatry Current Accepting new patients
Complete Care at Kresson View LLC Past Accepting new patients
Rowansom Dept of Pediatrics Past Accepting new patients
1086 Dumont Circle Opco LLC Past Accepting new patients

Locations

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

141 Route 70 E
Ste E
Marlton, NJ 08053
Phone (856) 985-7373

303 Lippincott Dr
Marlton, NJ 08053

42 E Laurel Rd
Ste 1800
Stratford, NJ 08084
Phone (609) 566-6843

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 12

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": "1340236800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710460800000",
    "number": "1750644928",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "42 E LAUREL RD STE 1800",
            "city": "STRATFORD",
            "state": "NJ",
            "postal_code": "080841338",
            "telephone_number": "856-566-6843",
            "fax_number": "856-566-6419"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "42 E LAUREL RD STE 1800",
            "city": "STRATFORD",
            "state": "NJ",
            "postal_code": "080841338",
            "telephone_number": "856-566-6843",
            "fax_number": "856-566-6419"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POWELL",
        "first_name": "LEONARD",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "D. O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-06-21",
        "last_updated": "2024-03-15",
        "certification_date": "2024-03-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NJ",
            "license": "25MB09553400",
            "primary": false
        },
        {
            "code": "207QG0300X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Geriatric Medicine",
            "state": "NJ",
            "license": "25MB09553400",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0480479",
            "state": "NJ"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "lpowell34984@directvirtua.org",
            "affiliation": "N",
            "address_1": "42 E Laurel Rd Ste 1800",
            "city": "Stratford",
            "state": "NJ",
            "country_code": "US",
            "postal_code": "080841338",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Stratford, NJ

Sources for this page

Verify at the official NPI Registry.