NPIMap

Individual provider Active NPI

Mignon Marie D'Guerra, M.D.

  • Family Medicine Physician
  • Moorestown, NJ
National Provider Identifier
1841586062
Registry record updated Oct 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
25MA09148000 Issued in NJ
Practice address
401 Young Ave Ste 260a
Moorestown, NJ 08057-3130
Phone
(856) 291-8756
Fax
(856) 291-8750
NPI assigned
Jun 27, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 22, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 25MA09148000 NJ Primary

Addresses

Primary practice location

401 Young Ave Ste 260a
Moorestown, NJ 08057-3130

Mailing address

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

Other identifiers 1

IdentifierTypeStateIssuer
0305855MedicaidNJ

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address mdguerra14208@directvirtua.org

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120920000128 NJ Practitioner - Family Practice 3779731559 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2008
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
Bordentown, NJ 08505-4517

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
25MA09148000NJMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Southern Jersey Family Medical Centers, Inc CurrentSince Jun 9, 2014 Accepting new patients
Virtua Medical Group, PA CurrentSince Jul 10, 2017 Accepting new patients
Southern Jersey Family Medical Centers, Inc CurrentSince Jun 9, 2014 Accepting new patients
Virtua Medical Group, PA Family Medicine CurrentSince Oct 25, 2020 Accepting new patients
Virtua Medical Group, PA CurrentSince Jul 10, 2017 Accepting new patients

Locations

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

651 High St
Burlington City, NJ 08016
Phone (609) 386-0775

860 S White Horse Pike
Hammonton, NJ 08037
Phone (609) 567-0200

303 Lippincott Dr
Marlton, NJ 08053

301 Lippincott Dr
Ste 410
Marlton, NJ 08053

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

401 Young Ave
Ste 260A
Moorestown, NJ 08057
Phone (856) 291-8756

401 Young Ave
Ste 260
Moorestown, NJ 08057
Phone (856) 291-8756

7000 Atrium Way
Ste 6
Mount Laurel, NJ 08054
Phone (856) 206-4500

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 and National Provider Directory roles.

Hospital & facility affiliations 10

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": "1309132800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603324800000",
    "number": "1841586062",
    "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"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 YOUNG AVE STE 260A",
            "city": "MOORESTOWN",
            "state": "NJ",
            "postal_code": "080573130",
            "telephone_number": "856-291-8756",
            "fax_number": "856-291-8750"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "D'GUERRA",
        "first_name": "MIGNON",
        "middle_name": "MARIE",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-06-27",
        "last_updated": "2020-10-22",
        "certification_date": "2020-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NJ",
            "license": "25MA09148000",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0305855",
            "state": "NJ"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mdguerra14208@directvirtua.org",
            "affiliation": "N",
            "address_1": "401 Young Ave Ste 260A",
            "city": "Moorestown",
            "state": "NJ",
            "country_code": "US",
            "postal_code": "080573130",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Moorestown, NJ

Sources for this page

Verify at the official NPI Registry.