Individual provider Active NPI

Nicole Marie Leopardi, MD

  • Pediatrics Physician
  • Stratford, NJ
National Provider Identifier
1861624637
Registry record updated Dec 20, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
25MA08739400 Issued in NJ
Practice address
42 E Laurel Rd Ste 1100
Stratford, NJ 08084-1354
Phone
(856) 566-7036
Fax
(856) 566-6108
NPI assigned
Aug 12, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 20, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 25MA08739400 NJ Primary

Addresses

Primary practice location

42 E Laurel Rd Ste 1100
Stratford, NJ 08084-1354

Mailing address

42 E Laurel Rd Ste 1100
Stratford, NJ 08084-1354
Phone (856) 566-7036

Other identifiers 2

IdentifierTypeStateIssuer
0235318MedicaidNJ
25MA08739400OtherNJSTATE LICENSE

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
I20101015000209 NJ Practitioner - Pediatric Medicine 0042403685 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Cooper Pediatrics Pediatrics CurrentSince Jul 1, 2010 Accepting new patients
Cooper Pediatric Specialists, PC Pediatrics Past Accepting new patients
Rowansom Cares Institute Pediatrics PastSince Dec 28, 2022 Accepting new patients
Rowansom Cares Institute PastSince Dec 28, 2022 Accepting new patients

Locations

3 Cooper Plz
Rm 200
Camden, NJ 08103
Phone (609) 342-2001

3 Cooper Plz
Rm 520
Camden, NJ 08103
Phone (856) 342-2298

3 Cooper Plz
Rm 502
Camden, NJ 08103
Phone (856) 342-2921

1 Federal St
Ste SW200
Camden, NJ 08103
Phone (856) 356-4920

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 and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1250035200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1671494400000",
    "number": "1861624637",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "42 E LAUREL RD STE 1100",
            "city": "STRATFORD",
            "state": "NJ",
            "postal_code": "080841354",
            "telephone_number": "856-566-7036",
            "fax_number": "856-566-6108"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "42 E LAUREL RD STE 1100",
            "city": "STRATFORD",
            "state": "NJ",
            "postal_code": "080841354",
            "telephone_number": "856-566-7036",
            "fax_number": "856-566-6108"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEOPARDI",
        "first_name": "NICOLE",
        "middle_name": "MARIE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-08-12",
        "last_updated": "2022-12-20",
        "certification_date": "2022-12-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NJ",
            "license": "25MA08739400",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0235318",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "25MA08739400",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Stratford, NJ

Sources for this page

Verify at the official NPI Registry.