Individual provider Active NPI

Ali M Mustafa

  • Pulmonary Disease Physician
  • Marlton, NJ
National Provider Identifier
1891226486
Registry record updated May 5, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pulmonary Disease PhysicianTaxonomy code 207RP1001X
License
25MA12129000 Issued in NJ
Practice address
Renaissance Square, 141 Route 70, Suite B
Marlton, NJ 08053
Phone
(856) 596-9057
Fax
(856) 596-0837
NPI assigned
Mar 24, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 5, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Hospitalist Physician 208M00000X 305207 NY
Student in an Organized Health Care Education/Training Program 390200000X
Pulmonary Disease Physician 207RP1001X 25MA12129000 NJ Primary

Addresses

Primary practice location

Renaissance Square, 141 Route 70, Suite B
Marlton, NJ 08053

Mailing address

301 Lippincott Dr Ste 410
Marlton, NJ 08053-4197
Phone (856) 596-9057

Other practice location 1

239 Hurffville Crosskeys Rd Ste 450
Sewell, NJ 08080-4009
Phone (856) 341-8390

Other practice location 2

1113 Hospital Dr Ste 305
Willingboro, NJ 08046-1130
Phone (856) 375-1288

Other practice location 3

401 Young Ave Ste 165
Moorestown, NJ 08057-3131
Phone (856) 235-4656

Other practice location 4

6500 Kevin Johnson Blvd., Suite 100B
Bordentown, NJ 08505
Phone (609) 444-5404

Other practice location 5

107 Berlin Rd
Cherry Hill, NJ 08034-3526
Phone (856) 429-1800

Other practice location 6

750 Route 73 S Ste 401
Marlton, NJ 08053-4145
Phone (856) 375-1288

Other practice location 7

1000 Atlantic Ave Ste 205E
Camden, NJ 08104-1132
Phone (856) 596-9057

Electronic endpoints 8

TypeEndpointUseAffiliation
Direct Messaging Address amustafa272855@directvirtua.org
Direct Messaging Address amustafa272855@directvirtua.org
Direct Messaging Address amustafa272855@directvirtua.org
Direct Messaging Address amustafa272855@directvirtua.org
Direct Messaging Address amustafa272855@directvirtua.org
Direct Messaging Address amustafa272855@directvirtua.org
Direct Messaging Address amustafa272855@directvirtua.org
Direct Messaging Address amustafa272855@directvirtua.org

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
I20240727000063 NJ Practitioner - Pulmonary Disease 8921344870 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pulmonary Disease
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Virtua Medical Group, PAGroup PAC ID 9830222397, 1,678 clinicians

Practice addresses (Care Compare)

100 Bowman Dr
Voorhees, NJ 08043-9612
Phone (856) 247-7260

1000 Atlantic Ave
Camden, NJ 08104-1132

141 Route 70 E
Marlton, NJ 08053-1855

1600 Haddon Ave
Camden, NJ 08103-3101

175 Madison Ave
Mount Holly, NJ 08060-2038

218 Sunset Rd
FL 5
Willingboro, NJ 08046-1110
Phone (609) 444-0359

3242 Route 206
Bordentown, NJ 08505-4517

750 Route 73 S
Suite 401
Marlton, NJ 08053-4145
Phone (856) 375-1288

90 Brick Rd
Marlton, NJ 08053-2177
Phone (856) 247-7260

Hospital & facility affiliations

  • West Jersey Hospital Hospital, Voorhees, NJ, CCN 310022
  • Virtua Our Lady of Lourdes Hospital Hospital, Camden, NJ, CCN 310029
  • Virtua Mount Holly Hospital Hospital, Mount Holly, NJ, CCN 310057
  • Virtua Willingboro Hospital Hospital, Willingboro, NJ, CCN 310061

Merit-based Incentive Payment System (MIPS)

Final score
81.15 of 100Reported as group
Quality
62.28
Promoting interoperability
100
Improvement activities
40
Cost
74.89

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
305207NYMDRegistered Nurse
25MA12129000NJMDPulmonary Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Virtua Medical Group, PA Hospitalist CurrentSince Aug 1, 2024 Accepting new patients
Virtua Medical Group, PA CurrentSince Aug 1, 2024 Accepting new patients

Locations

3242 Route 206
Ste 2
Bordentown, NJ 08505
Phone (609) 298-4340

1000 Atlantic Ave
Ste 205E
Camden, NJ 08104
Phone (856) 596-9057

107 Berlin Rd
Cherry Hill, NJ 08034
Phone (856) 429-1800

303 Lippincott Dr
Marlton, NJ 08053

750 Route 73 S
Ste 401
Marlton, NJ 08053
Phone (856) 332-0767

141 Route 70 E
Ste B
Marlton, NJ 08053
Phone (856) 596-9057

301 Lippincott Dr
Ste 410
Marlton, NJ 08053

303 Lippincott Dr
Ste 200
Marlton, NJ 08053
Phone (856) 355-0335

401 Young Ave
Ste 165
Moorestown, NJ 08057
Phone (856) 235-4656

239 Hurffville Crosskeys Rd
Ste 450
Sewell, NJ 08080
Phone (856) 341-8390

1113 Hospital Dr
Ste 305
Willingboro, NJ 08046
Phone (609) 835-3624

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": "1490313600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1746403200000",
    "number": "1891226486",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "301 LIPPINCOTT DR STE 410",
            "city": "MARLTON",
            "state": "NJ",
            "postal_code": "080534197",
            "telephone_number": "856-596-9057",
            "fax_number": "856-596-0837"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "RENAISSANCE SQUARE, 141 ROUTE 70, SUITE B",
            "city": "MARLTON",
            "state": "NJ",
            "postal_code": "08053",
            "telephone_number": "856-596-9057",
            "fax_number": "856-596-0837"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "239 Hurffville Crosskeys Rd Ste 450",
            "address_purpose": "LOCATION",
            "city": "Sewell",
            "state": "NJ",
            "postal_code": "080804009",
            "country_code": "US",
            "telephone_number": "856-341-8390",
            "fax_number": "856-341-8131",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1113 Hospital Dr Ste 305",
            "address_purpose": "LOCATION",
            "city": "Willingboro",
            "state": "NJ",
            "postal_code": "080461130",
            "country_code": "US",
            "telephone_number": "856-375-1288",
            "fax_number": "856-375-2325",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "401 Young Ave Ste 165",
            "address_purpose": "LOCATION",
            "city": "Moorestown",
            "state": "NJ",
            "postal_code": "080573131",
            "country_code": "US",
            "telephone_number": "856-235-4656",
            "fax_number": "856-235-4786",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "6500 Kevin Johnson Blvd., Suite 100B",
            "address_purpose": "LOCATION",
            "city": "Bordentown",
            "state": "NJ",
            "postal_code": "08505",
            "country_code": "US",
            "telephone_number": "609-444-5404",
            "fax_number": "609-444-5405",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "107 Berlin Rd",
            "address_purpose": "LOCATION",
            "city": "Cherry Hill",
            "state": "NJ",
            "postal_code": "080343526",
            "country_code": "US",
            "telephone_number": "856-429-1800",
            "fax_number": "856-429-1081",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "750 Route 73 S Ste 401",
            "address_purpose": "LOCATION",
            "city": "Marlton",
            "state": "NJ",
            "postal_code": "080534145",
            "country_code": "US",
            "telephone_number": "856-375-1288",
            "fax_number": "856-375-2325",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1000 Atlantic Ave Ste 205E",
            "address_purpose": "LOCATION",
            "city": "Camden",
            "state": "NJ",
            "postal_code": "081041132",
            "country_code": "US",
            "telephone_number": "856-596-9057",
            "fax_number": "856-596-0837",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MUSTAFA",
        "first_name": "ALI",
        "middle_name": "M",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-03-24",
        "last_updated": "2025-05-05",
        "certification_date": "2025-05-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "NY",
            "license": "305207",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "NJ",
            "license": "25MA12129000",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "amustafa272855@directvirtua.org",
            "affiliation": "N",
            "address_1": "6500 Kevin Johnson Blvd., Suite 100B",
            "city": "Bordentown",
            "state": "NJ",
            "country_code": "US",
            "postal_code": "08505",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "amustafa272855@directvirtua.org",
            "affiliation": "N",
            "address_1": "107 Berlin Rd",
            "city": "Cherry Hill",
            "state": "NJ",
            "country_code": "US",
            "postal_code": "080343526",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "amustafa272855@directvirtua.org",
            "affiliation": "N",
            "address_1": "750 Route 73 S Ste 401",
            "city": "Marlton",
            "state": "NJ",
            "country_code": "US",
            "postal_code": "080534145",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "amustafa272855@directvirtua.org",
            "affiliation": "N",
            "address_1": "401 Young Ave Ste 165",
            "city": "Moorestown",
            "state": "NJ",
            "country_code": "US",
            "postal_code": "080573131",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "amustafa272855@directvirtua.org",
            "affiliation": "N",
            "address_1": "239 Hurffville Crosskeys Rd Ste 450",
            "city": "Sewell",
            "state": "NJ",
            "country_code": "US",
            "postal_code": "080804009",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "amustafa272855@directvirtua.org",
            "affiliation": "N",
            "address_1": "1113 Hospital Dr Ste 305",
            "city": "Willingboro",
            "state": "NJ",
            "country_code": "US",
            "postal_code": "080461130",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "amustafa272855@directvirtua.org",
            "affiliation": "N",
            "address_1": "Renaissance Square, 141 Route 70, Suite B",
            "city": "Marlton",
            "state": "NJ",
            "country_code": "US",
            "postal_code": "08053",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "amustafa272855@directvirtua.org",
            "affiliation": "N",
            "address_1": "1000 Atlantic Ave Ste 205E",
            "city": "Camden",
            "state": "NJ",
            "country_code": "US",
            "postal_code": "081041132",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Marlton, NJ

Sources for this page

Verify at the official NPI Registry.