Individual provider Active NPI

Stephanie Dejesus, RN, APN, AGACNP-BC

  • Critical Care Medicine Nurse Practitioner
  • Marlton, NJ
National Provider Identifier
1992274245
Registry record updated Dec 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Critical Care Medicine Nurse PractitionerTaxonomy code 363LC0200X
License
26NJ00835000 Issued in NJ
Practice address
141 Route 70 E Ste B
Marlton, NJ 08053-1855
Phone
(856) 596-9057
Fax
(856) 596-0837
NPI assigned
Nov 15, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 19, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 26NR12453000 NJ
Critical Care Medicine Nurse Practitioner 363LC0200X 26NJ00835000 NJ Primary

Addresses

Primary practice location

141 Route 70 E Ste B
Marlton, NJ 08053-1855

Mailing address

301 Lippincott Dr Ste 410
Marlton, NJ 08053-4197
Phone (856) 355-0340

Other practice location 1

239 Hurffville Crosskeys Rd Ste 360A
Sewell, NJ 08080-4002
Phone (856) 341-8390

Other practice location 2

401 Young Ave Ste 165
Moorestown, NJ 08057-3131
Phone (856) 235-4656

Other identifiers 1

IdentifierTypeStateIssuer
0667030MedicaidNJ

Electronic endpoints 3

TypeEndpointUseAffiliation
Direct Messaging Address sdejesus25566@directvirtua.org
Direct Messaging Address sdejesus25566@directvirtua.org
Direct Messaging Address sdejesus25566@directvirtua.org

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
I20191216001076 NJ Practitioner - Nurse Practitioner 1759715246 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
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)

100 Bowman Dr
Voorhees, NJ 08043-9612
Phone (856) 247-7260

175 Madison Ave
Mount Holly, NJ 08060-2038

3242 Route 206
Bordentown, NJ 08505-4517

90 Brick Rd
Marlton, NJ 08053-2177
Phone (856) 247-7260

Hospital & facility affiliations

  • West Jersey Hospital Hospital, Voorhees, NJ, CCN 310022

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
Nurse Practitioner, Registered Nurse

State licenses

LicenseStateTypeSpecialty
26NJ00835000NJMDCritical Care Medicine Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Virtua Medical Group, PA CurrentSince Sep 17, 2019 Accepting new patients
Atlanticare Physician Group, PA CurrentSince Mar 9, 2026 Accepting new patients
Virtua Medical Group, PA Current Accepting new patients
Atlanticare Physician Group PA CurrentSince Mar 9, 2026 Accepting new patients
Jersey Intensivist Associates LLC CurrentSince Feb 17, 2021 Accepting new patients

Locations

1925 Pacific Ave
Atlantic City, NJ 08401
Phone (609) 441-8023

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

141 Route 70 E
Ste B
Marlton, NJ 08053
Phone (856) 596-9057

301 Lippincott Dr
Ste 410
Marlton, NJ 08053

401 Young Ave
Ste 165
Moorestown, NJ 08057
Phone (856) 235-4656

239 Hurffville Crosskeys Rd
Ste 360A
Sewell, NJ 08080
Phone (856) 341-8390

66 W Gilbert St
Ste 100
Tinton Falls, NJ 07701
Phone (201) 795-8637

1 Hamilton Health Pl
Trenton, NJ 08690
Phone (609) 584-6763

Interoperability endpoints

  • Direct secure messaging: sdejesus25566@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.

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": "1542240000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1734566400000",
    "number": "1992274245",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "301 LIPPINCOTT DR STE 410",
            "city": "MARLTON",
            "state": "NJ",
            "postal_code": "080534197",
            "telephone_number": "856-355-0340",
            "fax_number": "856-355-0330"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "141 ROUTE 70 E STE B",
            "city": "MARLTON",
            "state": "NJ",
            "postal_code": "080531855",
            "telephone_number": "856-596-9057",
            "fax_number": "856-596-0837"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "239 Hurffville Crosskeys Rd Ste 360A",
            "address_purpose": "LOCATION",
            "city": "Sewell",
            "state": "NJ",
            "postal_code": "080804002",
            "country_code": "US",
            "telephone_number": "856-341-8390",
            "fax_number": "856-341-8179",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "401 Young Ave Ste 165",
            "address_purpose": "LOCATION",
            "city": "Moorestown",
            "state": "NJ",
            "postal_code": "080573131",
            "country_code": "US",
            "telephone_number": "856-235-4656",
            "fax_number": "856-235-4786",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DEJESUS",
        "first_name": "STEPHANIE",
        "name_prefix": "Dr.",
        "credential": "RN, APN, AGACNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-11-15",
        "last_updated": "2024-12-19",
        "certification_date": "2024-12-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NJ",
            "license": "26NR12453000",
            "primary": false
        },
        {
            "code": "363LC0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Critical Care Medicine",
            "state": "NJ",
            "license": "26NJ00835000",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0667030",
            "state": "NJ"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "sdejesus25566@directvirtua.org",
            "affiliation": "N",
            "address_1": "239 Hurffville Crosskeys Rd Ste 360A",
            "city": "Sewell",
            "state": "NJ",
            "country_code": "US",
            "postal_code": "080804002",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "sdejesus25566@directvirtua.org",
            "affiliation": "N",
            "address_1": "141 Route 70 E Ste B",
            "city": "Marlton",
            "state": "NJ",
            "country_code": "US",
            "postal_code": "080531855",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "sdejesus25566@directvirtua.org",
            "affiliation": "N",
            "address_1": "401 Young Ave Ste 165",
            "city": "Moorestown",
            "state": "NJ",
            "country_code": "US",
            "postal_code": "080573131",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Marlton, NJ

Sources for this page

Verify at the official NPI Registry.