Active NPI
Mark J Pello, M.D.
- Colon & Rectal Surgery Physician
- Camden, NJ
National Provider Identifier
1073602546
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Colon & Rectal Surgery Physician
- License
- MA32132
- Practice address
- 3 Cooper PLZ RM 411
Cooper Surgical Associates
Camden, NJ 08103-1438 - Phone
- (856) 342-3412
- Fax
- (856) 365-1180
- NPI assigned
- Oct 12, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Colon & Rectal Surgery Physician | 208C00000X | MA32132 | NJ | Primary |
Addresses
Primary practice location
3 Cooper PLZ RM 411
Cooper Surgical Associates
Camden, NJ 08103-1438
Mailing address
3 Cooper PLZ
502
Camden, NJ 08103-1438
Phone (856) 968-7433
Other identifiers 11
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1010875 | Other | NJ | HORIZON NJ HEALTH |
| CA0000068 | Other | NJ | AMERICHOICE |
| 16735 | Other | NJ | AETNA |
| 6710804 | Other | NJ | CIGNA |
| P531590 | Other | NJ | OXFORD HEALTH PLAN |
| 3K6211 | Other | NJ | HEALTHNET |
| 400785 | Other | NJ | AMERIHEALTH PPO/PA BS |
| 1328701 | Medicaid | NJ | |
| 0097397000 | Other | NJ | AMERIHEALTH/KESYTONE/IBC |
| 1242926 | Other | NJ | UNITED HEALTHCARE |
| 22502 | Other | NJ | UNIVERSITY HEALTH PLAN |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MA32132 | NJ | MD | Colon & Rectal Surgery Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1160611200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1403049600000",
"number": "1073602546",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3 COOPER PLZ",
"address_2": "502",
"city": "CAMDEN",
"state": "NJ",
"postal_code": "081031438",
"telephone_number": "856-968-7433",
"fax_number": "856-968-8499"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3 COOPER PLZ RM 411",
"address_2": "COOPER SURGICAL ASSOCIATES",
"city": "CAMDEN",
"state": "NJ",
"postal_code": "081031438",
"telephone_number": "856-342-3412",
"fax_number": "856-365-1180"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PELLO",
"first_name": "MARK",
"middle_name": "J",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-10-12",
"last_updated": "2014-06-18",
"status": "A"
},
"taxonomies": [
{
"code": "208C00000X",
"taxonomy_group": "",
"desc": "Colon & Rectal Surgery",
"state": "NJ",
"license": "MA32132",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HORIZON NJ HEALTH",
"identifier": "1010875",
"state": "NJ"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AMERICHOICE",
"identifier": "CA0000068",
"state": "NJ"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA",
"identifier": "16735",
"state": "NJ"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CIGNA",
"identifier": "6710804",
"state": "NJ"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "OXFORD HEALTH PLAN",
"identifier": "P531590",
"state": "NJ"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HEALTHNET",
"identifier": "3K6211",
"state": "NJ"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AMERIHEALTH PPO/PA BS",
"identifier": "400785",
"state": "NJ"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1328701",
"state": "NJ"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AMERIHEALTH/KESYTONE/IBC",
"identifier": "0097397000",
"state": "NJ"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UNITED HEALTHCARE",
"identifier": "1242926",
"state": "NJ"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UNIVERSITY HEALTH PLAN",
"identifier": "22502",
"state": "NJ"
}
],
"endpoints": [],
"other_names": []
}Other providers in Camden, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.