Individual provider Active NPI

Dana Rokicsak, PA-C

  • Surgical Physician Assistant
  • Turnersville, NJ
National Provider Identifier
1851032700
Registry record updated Nov 14, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
028501 Issued in NY
Practice address
435 Hurffville Cross Keys Rd
Turnersville, NJ 08012-2453
Phone
(856) 513-4124
NPI assigned
Apr 5, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 14, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X 028501 NY Primary

Addresses

Primary practice location

435 Hurffville Cross Keys Rd
Turnersville, NJ 08012-2453

Mailing address

435 Hurffville Cross Keys Rd
Turnersville, NJ 08012-2453

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, NJ2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20221012001479 NY Practitioner - Physician Assistant 1658747910
I20230831004785 NJ Practitioner - Physician Assistant 1658747910 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Albany Medical College of Union University, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

18 E Laurel Rd
Stratford, NJ 08084-1327
Phone (856) 513-4124

2201 Chapel Ave W
Cherry Hill, NJ 08002-2048
Phone (856) 513-4124

2211 Chapel Ave W
301 Kha General Surgery
Cherry Hill, NJ 08002-2048
Phone (856) 665-2017

435 Hurffville Cross Keys Rd
Turnersville, NJ 08012-2453
Phone (856) 513-4124

457 Haddonfield Rd
Suite 110
Cherry Hill, NJ 08002-2223
Phone (844) 542-2273

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
028501NYMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Kennedy Medical Group Practice PC CurrentSince Sep 1, 2023 Accepting new patients
Kennedy Medical Group Practice, P.C. CurrentSince Sep 1, 2023 Accepting new patients

Locations

457 Haddonfield Rd
Ste 110
Cherry Hill, NJ 08002
Phone (856) 406-4091

435 Hurffville Cross Keys Rd
Turnersville, NJ 08012
Phone (856) 513-4124

Organizations & group practices 3

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 1

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": "1649116800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1699920000000",
    "number": "1851032700",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "435 HURFFVILLE CROSS KEYS RD",
            "city": "TURNERSVILLE",
            "state": "NJ",
            "postal_code": "080122453"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "435 HURFFVILLE CROSS KEYS RD",
            "city": "TURNERSVILLE",
            "state": "NJ",
            "postal_code": "080122453",
            "telephone_number": "856-513-4124"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROKICSAK",
        "first_name": "DANA",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-04-05",
        "last_updated": "2023-11-14",
        "certification_date": "2023-11-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "NY",
            "license": "028501",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Turnersville, NJ

Sources for this page

Verify at the official NPI Registry.