Individual provider Active NPI

Carla Y. Grovatt, PA-C

  • Physician Assistant
  • Medford, NJ
National Provider Identifier
1952330524
Registry record updated Jul 9, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
25MP00000700 Issued in NJ
Practice address
131 Route 70 W
Ste 100
Medford, NJ 08055
Phone
(609) 267-9400
Fax
(609) 267-9457
NPI assigned
Jul 3, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 25MP00000700 NJ Primary

Addresses

Primary practice location

131 Route 70 W
Ste 100
Medford, NJ 08055

Mailing address

4 Eves Dr Ste A100
Marlton, NJ 08053-3126
Phone (609) 267-9400

Other identifiers 1

IdentifierTypeStateIssuer
0342921MedicaidNJ

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
I20040528000534 NJ Practitioner - Physician Assistant 5193706778 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Virtua Medical Group, PAGroup PAC ID 9830222397, 1,678 clinicians

Practice addresses (Care Compare)

131 Route 70
Suite 100
Medford, NJ 08055-9501
Phone (856) 673-3960

3242 Route 206
Bordentown, NJ 08505-4517

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
Physician Assistant

State licenses

LicenseStateTypeSpecialty
25MP00000700NJMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Virtua Medical Group, PA Physician Assistant CurrentSince Jul 19, 2023 Accepting new patients
Virtua Medical Group, PA CurrentSince Jul 19, 2023 Accepting new patients
Alliance for Better Care, P.C. Past Accepting new patients
Atlantic Professional Services of New Jersey, P.a. Physician Assistant Past Accepting new patients
Virtua Medical Group, PA Past Accepting new patients

Locations

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

1613 Route 38
Lumberton, NJ 08048
Phone (609) 261-3716

131 Route 70
#100
Medford, NJ 08055
Phone (856) 630-7468

300 W Route 38
Moorestown, NJ 08057
Phone 60926794001224

300 W Route 38
Ste A
Moorestown, NJ 08057
Phone (856) 673-3960

200 Bowman Dr
Ste E100
Voorhees, NJ 08043
Phone (856) 673-3960

Interoperability endpoints

  • Direct secure messaging: cgrovatt78096@directvirtua.org

Organizations & group practices 5

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": "1151884800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1531094400000",
    "number": "1952330524",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4 EVES DR STE A100",
            "city": "MARLTON",
            "state": "NJ",
            "postal_code": "080533126",
            "telephone_number": "609-267-9400",
            "fax_number": "609-267-9457"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "131 ROUTE 70 W",
            "address_2": "STE 100",
            "city": "MEDFORD",
            "state": "NJ",
            "postal_code": "08055",
            "telephone_number": "609-267-9400",
            "fax_number": "609-267-9457"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GROVATT",
        "first_name": "CARLA",
        "middle_name": "Y.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-03",
        "last_updated": "2018-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NJ",
            "license": "25MP00000700",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0342921",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Medford, NJ

Sources for this page

Verify at the official NPI Registry.