NPIMap

Organization Active NPI

Chop Clinical Associates, Inc

  • Pediatrics Physician
  • Moorestown, NJ
National Provider Identifier
1891870432
Registry record updated Jan 22, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
Legal business name
CHOP CLINICAL ASSOCIATES, INC
Practice address
200 Marter Ave
Suite 100
Moorestown, NJ 08057-3114
Phone
(856) 235-2147
Fax
(856) 235-6905
NPI assigned
Oct 25, 2006
Organization subpart
Yes
Parent organization
CHOP CLINICAL ASSOCIATES, INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jan 22, 2025

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

Authorized official

Name
Fabian Stone
Title
VP Revenue Cycle
Phone
(267) 425-5765

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208000000X NJ Primary

Addresses

Primary practice location

200 Marter Ave
Suite 100
Moorestown, NJ 08057-3114

Mailing address

3401 Civic Center Blvd
Philadelphia, PA 19104-4319

Other identifiers 1

IdentifierTypeStateIssuer
2591502MedicaidNJ

Other names 1

  • CHOP Primary Care Moorestown Doing business as

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
31D0888000Chop Primary Care Moorestown200 Marter Ave, Moorestown, NJ 08057Certificate of waiverJan 20, 2027

National Provider Directory

National Provider Directory
Tax ID family
Chop Clinical Associates12 organizations share this tax ID, including this one
Part of
Chop Clinical Associates

Other organizations with this tax ID 11

Organizations that report the same tax identification number in the National Provider Directory.

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

NPI Registry JSON

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

{
    "created_epoch": "1161734400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1737504000000",
    "number": "1891870432",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3401 CIVIC CENTER BLVD",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191044319"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 MARTER AVE",
            "address_2": "SUITE 100",
            "city": "MOORESTOWN",
            "state": "NJ",
            "postal_code": "080573114",
            "telephone_number": "856-235-2147",
            "fax_number": "856-235-6905"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHOP CLINICAL ASSOCIATES, INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "CHOP CLINICAL ASSOCIATES, INC",
        "enumeration_date": "2006-10-25",
        "last_updated": "2025-01-22",
        "certification_date": "2025-01-22",
        "status": "A",
        "authorized_official_last_name": "STONE",
        "authorized_official_first_name": "FABIAN",
        "authorized_official_title_or_position": "VP REVENUE CYCLE",
        "authorized_official_telephone_number": "267-425-5765"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": "NJ",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2591502",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CHOP Primary Care Moorestown",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Moorestown, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.