Individual provider Active NPI

Phyllis L Fishbein, RN, APN

  • Family Nurse Practitioner
  • Cherry Hill, NJ
National Provider Identifier
1831475664
Registry record updated Jun 16, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
26NJ00349500 Issued in NJ
Practice address
19 E Ormond Avenue
Cherry Hill, NJ 08034-2053
Phone
(856) 428-7632
NPI assigned
Oct 25, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 16, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 26NJ00349500 NJ Primary

Addresses

Primary practice location

19 E Ormond Avenue
Cherry Hill, NJ 08034-2053

Mailing address

19 E Ormond Avenue
Cherry Hill, NJ 08034-2053
Phone (856) 428-7632

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
I20161130001816 NJ Practitioner - Nurse Practitioner 5890682116 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
NJ Memory and Behavioral CareGroup PAC ID 7719013267, 71 clinicians

Practice addresses (Care Compare)

14 Ridgedale Ave
Suite 103
Cedar Knolls, NJ 07927-1106
Phone (973) 295-6335

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as group

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner, Registered Nurse

State licenses

LicenseStateTypeSpecialty
26NJ00349500NJMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
NJ Memory and Behavioral Care CurrentSince Apr 1, 2019 Accepting new patients
Centerwell Certified Healthcare Corp PastSince Apr 30, 2003 Accepting new patients

Locations

14 Ridgedale Ave
Ste 103
Cedar Knolls, NJ 07927
Phone (973) 295-6335

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1319500800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1402876800000",
    "number": "1831475664",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19 E ORMOND AVENUE",
            "city": "CHERRY HILL",
            "state": "NJ",
            "postal_code": "080342053",
            "telephone_number": "856-428-7632"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19 E ORMOND AVENUE",
            "city": "CHERRY HILL",
            "state": "NJ",
            "postal_code": "080342053",
            "telephone_number": "856-428-7632"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FISHBEIN",
        "first_name": "PHYLLIS",
        "middle_name": "L",
        "name_prefix": "Ms.",
        "credential": "RN, APN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-10-25",
        "last_updated": "2014-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NJ",
            "license": "26NJ00349500",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cherry Hill, NJ

Sources for this page

Verify at the official NPI Registry.