Individual provider Active NPI

Maria Livecchi

  • Registered Nurse
  • Audubon, NJ
National Provider Identifier
1962293407
Registry record updated May 14, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
26NR26935300 Issued in NJ
Practice address
111 Hampshire Ave
Audubon, NJ 08106-2017
Phone
(609) 707-0677
NPI assigned
May 14, 2025
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 14, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 26NR26935300 NJ Primary

Addresses

Primary practice location

111 Hampshire Ave
Audubon, NJ 08106-2017

Mailing address

111 Hampshire Ave
Audubon, NJ 08106-2017
Phone (609) 707-0677

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
I20250903004326 NJ Practitioner - Nurse Practitioner 9739681313 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Jefferson Medical College of Thomas Jefferson University, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Kennedy Medical Group Practice, P.C.Group PAC ID 2860616877, 417 clinicians

Practice addresses (Care Compare)

2201 Chapel Ave W
Cherry Hill, NJ 08002-2048
Phone (856) 513-4124

Hospital & facility affiliations

  • Jefferson Stratford Hospital Hospital, Stratford, NJ, CCN 310086

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
26NR26935300NJMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Kennedy Medical Group Practice, P.C. CurrentSince Jun 15, 2021 Accepting new patients
Kennedy Medical Group Practice PC CurrentSince Aug 1, 2025 Accepting new patients
Kennedy Medical Group Practice P.C. CurrentSince Aug 1, 2025 Accepting new patients
Kennedy Medical Group Practice P.C. Past Accepting new patients

Locations

2201 Chapel Ave W
Cherry Hill, NJ 08002
Phone (856) 488-6500

457 Haddonfield Rd
Ste 110
Cherry Hill, NJ 08002
Phone (856) 406-4091

18 E Laurel Rd
Stratford, NJ 08084
Phone (856) 346-6000

Organizations & group practices 4

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 1

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": "1747180800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1747180800000",
    "number": "1962293407",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 HAMPSHIRE AVE",
            "city": "AUDUBON",
            "state": "NJ",
            "postal_code": "081062017",
            "telephone_number": "609-707-0677"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 HAMPSHIRE AVE",
            "city": "AUDUBON",
            "state": "NJ",
            "postal_code": "081062017",
            "telephone_number": "609-707-0677"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIVECCHI",
        "first_name": "MARIA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-05-14",
        "last_updated": "2025-05-14",
        "certification_date": "2025-04-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NJ",
            "license": "26NR26935300",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Audubon, NJ

Sources for this page

Verify at the official NPI Registry.