Individual provider Active NPI

Thomas Joseph Killeen III, M.D.

  • Pediatrics Physician
  • Marlton, NJ
National Provider Identifier
1902126121
Registry record updated Oct 11, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
25MA9320100 Issued in NJ
Practice address
402 Lippincott Dr
Marlton, NJ 08053-4112
Phone
(856) 782-3300
NPI assigned
Jun 10, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 11, 2013

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 25MA9320100 NJ Primary

Addresses

Primary practice location

402 Lippincott Dr
Marlton, NJ 08053-4112

Mailing address

402 Lippincott Dr
Marlton, NJ 08053-4112
Phone (856) 782-3300

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
I20170612000585 NJ Practitioner - Pediatric Medicine 2062647829 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Advocare, LLC Pediatrics CurrentSince May 15, 2017 Accepting new patients
Advocare , LLC CurrentSince May 15, 2017 Accepting new patients
Advocare, LLC Pediatrics Past Accepting new patients

Locations

132 Grove St
Ste A
Haddonfield, NJ 08033
Phone (856) 354-2211

220 N Haddon Ave
Haddonfield, NJ 08033
Phone (856) 429-6719

975 Tuckerton Rd
Marlton, NJ 08053
Phone (856) 983-6675

402 Lippincott Dr
Marlton, NJ 08053
Phone (410) 763-8787

401 Route 73 N
Ste 320
Marlton, NJ 08053
Phone (609) 471-1033

25 Lindsley Dr
Ste 205
Morristown, NJ 07960
Phone (973) 993-8777

Interoperability endpoints

  • Direct secure messaging: thomas.killeen@advocaredoctors.eclinicaldirectplus.com

Organizations & group practices 3

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": "1276128000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1381449600000",
    "number": "1902126121",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "402 LIPPINCOTT DR",
            "city": "MARLTON",
            "state": "NJ",
            "postal_code": "080534112",
            "telephone_number": "856-782-3300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "402 LIPPINCOTT DR",
            "city": "MARLTON",
            "state": "NJ",
            "postal_code": "080534112",
            "telephone_number": "856-782-3300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KILLEEN",
        "first_name": "THOMAS",
        "middle_name": "JOSEPH",
        "name_prefix": "Dr.",
        "name_suffix": "III",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-06-10",
        "last_updated": "2013-10-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NJ",
            "license": "25MA9320100",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Marlton, NJ

Sources for this page

Verify at the official NPI Registry.