Individual provider Active NPI

Paul R Lanza, D.O.

  • Family Medicine Physician
  • Moorestown, NJ
National Provider Identifier
1851320311
Registry record updated Aug 22, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
25MB046409000 Issued in NJ
Practice address
728 Marne Hwy
Suite B
Moorestown, NJ 08057-3128
Phone
(856) 235-6600
Fax
(856) 235-6610
NPI assigned
Jun 30, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2014

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 25MB046409000 NJ Primary

Addresses

Primary practice location

728 Marne Hwy
Suite B
Moorestown, NJ 08057-3128

Mailing address

500 Grove St
Suite 100
Haddon Heights, NJ 08035-1761
Phone (856) 796-9200

Other identifiers 1

IdentifierTypeStateIssuer
1794701MedicaidNJ

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
I20100205000180 NJ Practitioner - Family Practice 5597808055 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Des Moines University of Osteopathic Medicine and Health Sciences, 1984
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Inspira Health Network Urgent Care PCGroup PAC ID 2769657659, 43 clinicians

Practice addresses (Care Compare)

200 Rowan Blvd
Glassboro, NJ 08028-2260
Phone (856) 582-1500

Hospital & facility affiliations

  • Inspira Medical Center Mullica Hill Hospital, Elmer, NJ, CCN 310069

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
25MB046409000NJMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Inspira Health Network Urgent Care, P.C. CurrentSince Aug 19, 2018 Accepting new patients
Alliance for Better Care, P.C. Family Medicine Past Accepting new patients
Virtua Medical Group, PA Family Medicine Past Accepting new patients
Inspira Health Network Medical Group, P.C. Past Accepting new patients
South Jersey Urgicare LLC PastSince Jul 1, 2014 Accepting new patients

Locations

200 Rowan Blvd
Glassboro, NJ 08028
Phone (856) 582-0500

1120 Delsea Dr N
Glassboro, NJ 08028
Phone (856) 205-7071

Organizations & group practices 6

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 3

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": "1151625600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1408665600000",
    "number": "1851320311",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 GROVE ST",
            "address_2": "SUITE 100",
            "city": "HADDON HEIGHTS",
            "state": "NJ",
            "postal_code": "080351761",
            "telephone_number": "856-796-9200",
            "fax_number": "856-796-9397"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "728 MARNE HWY",
            "address_2": "SUITE B",
            "city": "MOORESTOWN",
            "state": "NJ",
            "postal_code": "080573128",
            "telephone_number": "856-235-6600",
            "fax_number": "856-235-6610"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LANZA",
        "first_name": "PAUL",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-30",
        "last_updated": "2014-08-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NJ",
            "license": "25MB046409000",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1794701",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Moorestown, NJ

Sources for this page

Verify at the official NPI Registry.