NPIMap

Individual provider Active NPI

Dylan James McDivitt, DO

  • Family Medicine Physician
  • Woodstown, NJ
National Provider Identifier
1841783438
Registry record updated Jan 21, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
25MB10990100 Issued in NJ
Practice address
125 East Ave Ste C
Woodstown, NJ 08098-1351
Phone
(856) 769-2800
Fax
(856) 769-4256
NPI assigned
Jun 8, 2018
Last updated
Jan 21, 2025By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 21, 2025

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 25MB10990100 NJ Primary

Addresses

Primary practice location

125 East Ave Ste C
Woodstown, NJ 08098-1351

Mailing address

786 Carteret CT
Mount Laurel, NJ 08054-3205
Phone (856) 641-8000

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
I20241012000267 NJ Practitioner - Family Practice 6305248824 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Rowan University School of Osteopathic Medicine, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

125 E Ave C
Cchi Family Practice NJ
Woodstown, NJ 08098-1351
Phone (856) 769-2800

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Christiana Care Health Initiatives CurrentSince Sep 30, 2024 Accepting new patients
Christiana Care Health Initiatives CurrentSince Sep 30, 2024 Accepting new patients
Christiana Care Health Initiatives Family Medicine Current Accepting new patients
Christiana Care Health Initiatives Family Medicine Past Accepting new patients

Locations

125 East Ave
Ste C
Woodstown, NJ 08098
Phone (856) 769-2800

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 7

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": "1528416000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1737417600000",
    "number": "1841783438",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "786 CARTERET CT",
            "city": "MOUNT LAUREL",
            "state": "NJ",
            "postal_code": "080543205",
            "telephone_number": "856-641-8000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "125 EAST AVE STE C",
            "city": "WOODSTOWN",
            "state": "NJ",
            "postal_code": "080981351",
            "telephone_number": "856-769-2800",
            "fax_number": "856-769-4256"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCDIVITT",
        "first_name": "DYLAN",
        "middle_name": "JAMES",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-06-08",
        "last_updated": "2025-01-21",
        "certification_date": "2025-01-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NJ",
            "license": "25MB10990100",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Woodstown, NJ

Sources for this page

Verify at the official NPI Registry.