Individual provider Active NPI

Pauline Vanna Heiden, APN

  • Acute Care Nurse Practitioner
  • Camden, NJ
National Provider Identifier
1922649078
Registry record updated Nov 1, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
26NJ00977900 Issued in NJ
Practice address
1 Cooper PLZ
Camden, NJ 08103-1461
Phone
(800) 826-6737
NPI assigned
Sep 30, 2019
Last updated
Nov 1, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 1, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X 0000000000 NJ
Acute Care Nurse Practitioner 363LA2100X 26NJ00977900 NJ Primary

Addresses

Primary practice location

1 Cooper PLZ
Camden, NJ 08103-1461

Mailing address

1 Federal St # 200
Camden, NJ 08103-1088
Phone (856) 356-4924

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
I20191126002835 NJ Practitioner - Nurse Practitioner 8325471618 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cooper University Trauma Physicians, PCGroup PAC ID 3678569951, 54 clinicians

Practice addresses (Care Compare)

1 Cooper PLZ
Camden, NJ 08103-1461
Phone (856) 342-3014

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
86.83 of 100Reported as group
Quality
72.67
Promoting interoperability
99
Improvement activities
40
Cost
57.49

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0000000000NJMDAcute Care Nurse Practitioner
26NJ00977900NJMDAcute Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Cooper Surgical Associates, PA CurrentSince Nov 1, 2019 Accepting new patients
Cooper Surgical Associates, PA CurrentSince Nov 1, 2019 Accepting new patients
Cooper University Trauma Physicians, PC CurrentSince Nov 1, 2019 Accepting new patients

Locations

1 Cooper Plz
Camden, NJ 08103
Phone (856) 342-2425

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

3 Cooper Plz
Rm 411
Camden, NJ 08103
Phone (856) 342-2270

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 2

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": "1569801600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1572566400000",
    "number": "1922649078",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 FEDERAL ST # 200",
            "city": "CAMDEN",
            "state": "NJ",
            "postal_code": "081031088",
            "telephone_number": "856-356-4924"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 COOPER PLZ",
            "city": "CAMDEN",
            "state": "NJ",
            "postal_code": "081031461",
            "telephone_number": "800-826-6737"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HEIDEN",
        "first_name": "PAULINE",
        "middle_name": "VANNA",
        "name_prefix": "Mrs.",
        "credential": "APN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-09-30",
        "last_updated": "2019-11-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "NJ",
            "license": "0000000000",
            "primary": false
        },
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "NJ",
            "license": "26NJ00977900",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Camden, NJ

Sources for this page

Verify at the official NPI Registry.