Individual provider Active NPI

Jacquelyn N Copeland, MD

  • Diagnostic Radiology Physician
  • Hackensack, NJ
National Provider Identifier
1083932404
Registry record updated Nov 17, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
25MA09888200 Issued in NJ
Practice address
30 Prospect Ave Radiology Dept
Hackensack, NJ 07601-1915
Phone
(551) 996-2200
NPI assigned
May 10, 2010
Last updated
Nov 17, 2022By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 17, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 25MA09888200 NJ Primary

Addresses

Primary practice location

30 Prospect Ave Radiology Dept
Hackensack, NJ 07601-1915

Mailing address

130 Kinderkamack Rd Ste 200
River Edge, NJ 07661-1931
Phone (201) 488-2660

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ, CT2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20160628001422 NJ Practitioner - Diagnostic Radiology 3577870724 Reassigns benefits to 5 organizations
I20230426000601 CT Practitioner - Diagnostic Radiology 3577870724 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Hackensack Radiology Group PAGroup PAC ID 9830096361, 48 clinicians
Imaging North LLCGroup PAC ID 9133514987, 43 clinicians
New Century Imaging LLCGroup PAC ID 4082517370, 61 clinicians

Practice addresses (Care Compare)

30 Prospect Ave
Hackensack, NJ 07601-1915
Phone (201) 488-2660

5 Marine View PLZ
Suite 100
Hoboken, NJ 07030-5752
Phone (201) 488-2660

555 Kinderkamack Rd
Oradell, NJ 07649-1517
Phone (201) 488-2660

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
91.5 of 100Reported as group
Quality
90
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
91.5 of 100Reported as group
Quality
90
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Quality
100
Improvement activities
40

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Stamford Health Medical Group Inc CurrentSince Apr 3, 2023 Accepting new patients
Hackensack Meridian Health Medical Group - Specialty Care PC CurrentSince Sep 23, 2025 Accepting new patients
Hackensack Meridian Health Medical Group - Specialty Care PC CurrentSince Sep 23, 2025 Accepting new patients
Imaging North LLC Diagnostic Radiology CurrentSince Oct 1, 2022 Accepting new patients
Hackensack Radiology Group PA Diagnostic Radiology CurrentSince Oct 1, 2022 Accepting new patients
Englewood Radiologic Group P a Diagnostic Radiology CurrentSince Jun 1, 2016 Accepting new patients
New Century Imaging LLC Diagnostic Radiology CurrentSince Oct 1, 2022 Accepting new patients

Locations

1 Hospital Plz
Stamford, CT 06902
Phone (203) 276-4925

5 High Ridge Park
Ste 103
Stamford, CT 06905
Phone (203) 276-4644

1 Metro Blvd
Ste 1A
Clifton, NJ 07014

350 Engle St
Englewood, NJ 07631
Phone (201) 871-6073

30 Prospect Ave
Hackensack, NJ 07601
Phone (201) 488-0066

30 S Newman St
Hackensack, NJ 07601
Phone (201) 488-1188

5 Marine View Plz
Ste 100
Hoboken, NJ 07030

7600 River Rd
North Bergen, NJ 07047
Phone (201) 854-5000

555 Kinderkamack Rd
Oradell, NJ 07649
Phone (201) 261-2400

650 From Rd
Ste 130
Paramus, NJ 07652
Phone (551) 996-4788

130 Kinderkamack Rd
Ste 200
River Edge, NJ 07661

250 Old Hook Rd
Westwood, NJ 07675
Phone (201) 358-3000

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/ABCIBA
  • FHIR API: https://fhir4.healow.com/fhir/r4/IHJHBD

Organizations & group practices 7

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 5

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": "1273449600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1668643200000",
    "number": "1083932404",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "130 KINDERKAMACK RD STE 200",
            "city": "RIVER EDGE",
            "state": "NJ",
            "postal_code": "076611931",
            "telephone_number": "201-488-2660"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30 PROSPECT AVE RADIOLOGY DEPT",
            "city": "HACKENSACK",
            "state": "NJ",
            "postal_code": "076011915",
            "telephone_number": "551-996-2200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COPELAND",
        "first_name": "JACQUELYN",
        "middle_name": "N",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-05-10",
        "last_updated": "2022-11-17",
        "certification_date": "2022-11-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "NJ",
            "license": "25MA09888200",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hackensack, NJ

Sources for this page

Verify at the official NPI Registry.