Individual provider Active NPI

Stephen Michael Cooper, MD

  • Pediatrics Physician
  • Elkins Park, PA
National Provider Identifier
1114002565
Registry record updated Aug 19, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
MD494553 Issued in PA
Practice address
1939 W Cheltenham Ave
Elkins Park, PA 19027-1046
Phone
(215) 884-5715
Fax
(215) 884-1442
NPI assigned
Oct 26, 2006
Last updated
Aug 19, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 19, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X MD494553 PA Primary

Addresses

Primary practice location

1939 W Cheltenham Ave
Elkins Park, PA 19027-1046

Mailing address

1939 W Cheltenham Ave
Elkins Park, PA 19027-1046
Phone (215) 884-5715

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD
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
I20090130000146 MD Practitioner - Pediatric Medicine 8921162348 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pediatric Medicine
Education
University of Vermont College of Medicine, 1980
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

12137 Elm St
Princess Anne, MD 21853-1358
Phone (410) 651-1000

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
D0029665MDMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Three Lower Counties Community Services, Inc. CurrentSince Mar 17, 2010 Accepting new patients
Three Lower Counties Community Services, Inc. CurrentSince Mar 17, 2010 Accepting new patients
Three Lower Counties Community Services Inc Current Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients
Three Lower Counties Community Services, Inc. Past Accepting new patients

Locations

12145 Elm St
Princess Anne, MD 21853
Phone (410) 651-2204

12137 Elm St
Princess Anne, MD 21853
Phone (410) 651-1000

223 Phillip Morris Dr
Salisbury, MD 21804
Phone (410) 546-2424

100 Power St
Salisbury, MD 21804
Phone (410) 543-2060

Interoperability endpoints

  • Direct secure messaging: stephen.cooper.1@3167.direct.athenahealth.com

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1161820800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1787097600000",
    "number": "1114002565",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1939 W CHELTENHAM AVE",
            "city": "ELKINS PARK",
            "state": "PA",
            "postal_code": "190271046",
            "telephone_number": "215-884-5715",
            "fax_number": "215-884-1442"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1939 W CHELTENHAM AVE",
            "city": "ELKINS PARK",
            "state": "PA",
            "postal_code": "190271046",
            "telephone_number": "215-884-5715",
            "fax_number": "215-884-1442"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COOPER",
        "first_name": "STEPHEN",
        "middle_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-26",
        "last_updated": "2026-08-19",
        "certification_date": "2026-08-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "PA",
            "license": "MD494553",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Elkins Park, PA

Sources for this page

Verify at the official NPI Registry.