Individual provider Active NPI

Melanie Ann Powell, DO

  • Family Medicine Physician
  • Bordentown, NJ
National Provider Identifier
1811973464
Registry record updated Jun 1, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
25MB07322800 Issued in NJ
Practice address
3242 Route 206 Ste A2
Bordentown, NJ 08505-4517
Phone
(609) 298-4340
Fax
(609) 298-4370
NPI assigned
Dec 15, 2005
Last updated
Jun 1, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 1, 2021

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 25MB07322800 NJ Primary
Family Medicine Physician 207Q00000X OS013108 PA

Addresses

Primary practice location

3242 Route 206 Ste A2
Bordentown, NJ 08505-4517

Mailing address

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

Other identifiers 10

IdentifierTypeStateIssuer
3689108OtherPAAETNA HMO
3Y7157OtherPAHEALTH NET
450480OtherPACOVENTRY HEALTH AMERICA
P00258118OtherPARAIL ROAD MEDICARE
11316OtherPABRAVO HEALTH
2301780000OtherPAINDEPENDENCE BLUE CROSS
30021765OtherPAKEYSTONE MERCY HEALTH
1625078OtherPAHIGHMARK BLUE SHIELD
7884513OtherPAAETNA PPO
101692254MedicaidPA

Other names 1

  • Melanie Ann Williams Former name

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address mpowell13601@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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170620002344 NJ Practitioner - Family Practice 8820063118 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Philadelphia College of Osteopathic Medicine, 2000
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)

3242 Route 206
BLDG a
Bordentown, NJ 08505-4517
Phone (609) 298-4340

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Virtua Medical Group, PA Family Medicine Current Accepting new patients
Virtua Medical Group, PA CurrentSince Apr 19, 2017 Accepting new patients
Virtua Surgical Group, P.a Past Accepting new patients
Temple Physicians Inc Family Medicine 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

301 Lippincott Dr
Ste 410
Marlton, NJ 08053

303 Lippincott Dr
Marlton, NJ 08053

Interoperability endpoints

  • Direct secure messaging: mpowell13601@directvirtua.org

Organizations & group practices 4

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 5

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": "1134604800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1622505600000",
    "number": "1811973464",
    "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": "856-355-0330"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3242 ROUTE 206 STE A2",
            "city": "BORDENTOWN",
            "state": "NJ",
            "postal_code": "085054517",
            "telephone_number": "609-298-4340",
            "fax_number": "609-298-4370"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POWELL",
        "first_name": "MELANIE",
        "middle_name": "ANN",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-12-15",
        "last_updated": "2021-06-01",
        "certification_date": "2021-06-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NJ",
            "license": "25MB07322800",
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "PA",
            "license": "OS013108",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA HMO",
            "identifier": "3689108",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH NET",
            "identifier": "3Y7157",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "COVENTRY HEALTH AMERICA",
            "identifier": "450480",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAIL ROAD MEDICARE",
            "identifier": "P00258118",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BRAVO HEALTH",
            "identifier": "11316",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDEPENDENCE BLUE CROSS",
            "identifier": "2301780000",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "KEYSTONE MERCY HEALTH",
            "identifier": "30021765",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HIGHMARK BLUE SHIELD",
            "identifier": "1625078",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA PPO",
            "identifier": "7884513",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "101692254",
            "state": "PA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mpowell13601@directvirtua.org",
            "affiliation": "N",
            "address_1": "3242 Route 206 Ste A2",
            "city": "Bordentown",
            "state": "NJ",
            "country_code": "US",
            "postal_code": "085054517",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "MELANIE",
            "last_name": "WILLIAMS",
            "middle_name": "ANN",
            "credential": "DO",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Bordentown, NJ

Sources for this page

Verify at the official NPI Registry.