Individual provider Active NPI

Roanna Espino Alcera, M.D.

  • Family Medicine Physician
  • Hainesport, NJ
National Provider Identifier
1992960991
Registry record updated Oct 20, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
25MA08448900 Issued in NJ
Practice address
103 Creek Crossing Boulevard
Hainesport, NJ 08036
Phone
(609) 491-7021
Fax
(609) 784-8300
NPI assigned
Jul 19, 2008
Last updated
Oct 20, 2020By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 20, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 25MA08448900 NJ Primary

Addresses

Primary practice location

103 Creek Crossing Boulevard
Hainesport, NJ 08036

Mailing address

103 Creek Crossing Boulevard
Hainesport, NJ 08036
Phone (609) 491-7021

Other identifiers 1

IdentifierTypeStateIssuer
0174131MedicaidNJ

Electronic endpoints 3

TypeEndpointUseAffiliation
Direct Messaging Address ralcera14288@directvirtua.org
Direct Messaging Address ralcera14288@directvirtua.org
Direct Messaging Address ralcera14288@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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20081023000502 NJ Practitioner - Family Practice 8123186954 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Saint Louis University School of Medicine, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

103 Creek Crossing Blvd
Hainesport, NJ 08036-2765
Phone (609) 491-7021

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
25MA08448900NJMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Roanna Espino Alcera MD PC Family Medicine CurrentSince Dec 6, 2016 Accepting new patients
Genesis Wellness Medical Center LLC PastSince Dec 10, 2011 Accepting new patients
South Jersey Medicine and Geriatrics, PC PastSince Dec 6, 2016 Accepting new patients

Locations

103 Creek Crossing Blvd
Hainesport, NJ 08036
Phone (609) 491-7021

Interoperability endpoints

  • Direct secure messaging: ralcera14288@directvirtua.org

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": "1216425600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603152000000",
    "number": "1992960991",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "103 CREEK CROSSING BOULEVARD",
            "city": "HAINESPORT",
            "state": "NJ",
            "postal_code": "08036",
            "telephone_number": "609-491-7021",
            "fax_number": "609-784-8300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "103 CREEK CROSSING BOULEVARD",
            "city": "HAINESPORT",
            "state": "NJ",
            "postal_code": "08036",
            "telephone_number": "609-491-7021",
            "fax_number": "609-784-8300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ALCERA",
        "first_name": "ROANNA",
        "middle_name": "ESPINO",
        "name_prefix": "Mrs.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-07-19",
        "last_updated": "2020-10-20",
        "certification_date": "2020-10-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NJ",
            "license": "25MA08448900",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0174131",
            "state": "NJ"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ralcera14288@directvirtua.org",
            "affiliation": "N",
            "address_1": "1001 Route 73 N",
            "city": "Marlton",
            "state": "NJ",
            "country_code": "US",
            "postal_code": "080534524",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ralcera14288@directvirtua.org",
            "affiliation": "N",
            "address_1": "315 Route 70 E",
            "city": "Cherry Hill",
            "state": "NJ",
            "country_code": "US",
            "postal_code": "080342408",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ralcera14288@directvirtua.org",
            "affiliation": "N",
            "address_1": "128 Route 70 Ste 1",
            "city": "Medford",
            "state": "NJ",
            "country_code": "US",
            "postal_code": "080552371",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Hainesport, NJ

Sources for this page

Verify at the official NPI Registry.