Individual provider Active NPI

Gregory J. Zieniuk, M.D.

  • Pediatrics Physician
  • Voorhees, NJ
National Provider Identifier
1811139710
Registry record updated Oct 29, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
25MA09055300 Issued in NJ
Practice address
100 Bowman Dr
Chop Care Network at Virtua - Voorhees
Voorhees, NJ 08043-9612
Phone
(856) 325-3000
Fax
(609) 261-5842
NPI assigned
Mar 24, 2009
Last updated
Oct 29, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 29, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X MD444659 PA
Pediatrics Physician 208000000X 25MA09055300 NJ Primary

Addresses

Primary practice location

100 Bowman Dr
Chop Care Network at Virtua - Voorhees
Voorhees, NJ 08043-9612

Mailing address

100 E Penn SQ
9TH Floor
Philadelphia, PA 19107-3323
Phone (267) 425-9232

Other identifiers 1

IdentifierTypeStateIssuer
1027285300002MedicaidPA

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130221000160 NJ Practitioner - Emergency MedicinePractitioner - Pediatric Medicine 4981859006 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD444659PAMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Childrens Health Care Associates of New Jersey PC Pediatrics Current Accepting new patients
Childens Health Care Associates of New Jersey PC CurrentSince Jan 16, 2013 Accepting new patients
Children's Healthcare Associates of New Jersey PC CurrentSince Jan 16, 2013 Accepting new patients
Virtua - Memorial Hospital Burlington County, Inc. Past Accepting new patients
Virtua - West Jersey Health System, Inc. Past Accepting new patients

Locations

707 Alexander Rd
Princeton, NJ 08540
Phone (609) 520-1717

100 Bowman Dr
Voorhees, NJ 08043
Phone (856) 247-3000

1012 Laurel Oak Rd
Voorhees, NJ 08043
Phone (856) 435-0086

100 E Penn Sq
Fl 9
Philadelphia, PA 19107
Phone (267) 425-9232

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": "1237852800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603929600000",
    "number": "1811139710",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 E PENN SQ",
            "address_2": "9TH FLOOR",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191073323",
            "telephone_number": "267-425-9232",
            "fax_number": "267-425-9299"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 BOWMAN DR",
            "address_2": "CHOP CARE NETWORK AT VIRTUA - VOORHEES",
            "city": "VOORHEES",
            "state": "NJ",
            "postal_code": "080439612",
            "telephone_number": "856-325-3000",
            "fax_number": "609-261-5842"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZIENIUK",
        "first_name": "GREGORY",
        "middle_name": "J.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-03-24",
        "last_updated": "2020-10-29",
        "certification_date": "2020-10-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "PA",
            "license": "MD444659",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NJ",
            "license": "25MA09055300",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1027285300002",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Voorhees, NJ

Sources for this page

Verify at the official NPI Registry.