Individual provider Active NPI

Kasey Alexis Tankelewicz, CRNP

  • Family Nurse Practitioner
  • Marlton, NJ
National Provider Identifier
1861374068
Registry record updated Jul 21, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
SP033169 Issued in PA
Practice address
73 N Maple Ave
Marlton, NJ 08053-1782
Phone
(856) 352-6660
NPI assigned
Jul 21, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 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 Nurse Practitioner 363LF0000X SP033169 PA Primary

Addresses

Primary practice location

73 N Maple Ave
Marlton, NJ 08053-1782

Mailing address

15033 Endicott St
Philadelphia, PA 19116-1530
Phone (267) 690-4879

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
I20251124003253 NJ Practitioner - Nurse Practitioner 8022500396 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Kennedy Medical Group Practice, P.C.Group PAC ID 2860616877, 417 clinicians

Practice addresses (Care Compare)

301 Route 73 N
West Berlin Pands Care
West Berlin, NJ 08091-2508
Phone (856) 922-0058

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

73 N Maple Ave B
Kennedy Health Alliance
Marlton, NJ 08053-1782
Phone (844) 542-2273

Hospital & facility affiliations

  • Jefferson Stratford Hospital Hospital, Stratford, NJ, CCN 310086
  • Thomas Jefferson University Hospital Hospital, Philadelphia, PA, CCN 390174
  • Jefferson Health- Northeast Hospital, Philadelphia, PA, CCN 390115
  • Jefferson Abington Hospital Hospital, Abington, PA, CCN 390231

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
SP033169PAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Kennedy Medical Group Practice PC CurrentSince Nov 1, 2025 Accepting new patients
Kennedy Medical Group Practice, P.C. CurrentSince Nov 1, 2025 Accepting new patients

Locations

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

73 N Maple Ave
Marlton, NJ 08053
Phone (856) 352-6660

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.

Hospital & facility affiliations 4

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": "1753056000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1753056000000",
    "number": "1861374068",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15033 ENDICOTT ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191161530",
            "telephone_number": "267-690-4879"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "73 N MAPLE AVE",
            "city": "MARLTON",
            "state": "NJ",
            "postal_code": "080531782",
            "telephone_number": "856-352-6660"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TANKELEWICZ",
        "first_name": "KASEY",
        "middle_name": "ALEXIS",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-07-21",
        "last_updated": "2025-07-21",
        "certification_date": "2025-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "PA",
            "license": "SP033169",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Marlton, NJ

Sources for this page

Verify at the official NPI Registry.