Individual provider Active NPI

Brian S. Cooper, MD

  • Clinical Cardiac Electrophysiology Physician
  • Fort Wayne, IN
National Provider Identifier
1134286792
Registry record updated Aug 14, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Cardiac Electrophysiology PhysicianTaxonomy code 207RC0001X
License
01088709A Issued in IN
Practice address
7916 W Jefferson Blvd
Fort Wayne, IN 46804-4140
Phone
(260) 432-2297
Fax
(260) 479-4602
NPI assigned
Jan 3, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 14, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Cardiac Electrophysiology Physician 207RC0001X 01088709A IN Primary

Addresses

Primary practice location

7916 W Jefferson Blvd
Fort Wayne, IN 46804-4140

Mailing address

6920 Pointe Inverness Way Ste 200
Fort Wayne, IN 46804-7934
Phone (260) 479-3514

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address brian.cooper@lutheranhealthnetwork.cernerdirect.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN, IN2 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
I20130918000272 TN Practitioner - Cardiac ElectrophysiologyPractitioner - Cardiovascular Disease (Cardiology) 1355585175
I20221104001684 IN Practitioner - Cardiac Electrophysiology 1355585175 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Cardiac Electrophysiology
Education
Temple University School of Medicine, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lutheran Medical Group LLCGroup PAC ID 4981751617, 251 clinicians

Practice addresses (Care Compare)

7916 W Jefferson Blvd
Fort Wayne, IN 46804-4140
Phone (260) 432-2297

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
90.99 of 100Reported as apm
Quality
77.41
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Pacemaker insertion or repair44

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
01088709AINMDClinical Cardiac Electrophysiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Lutheran Medical Group LLC Internal Medicine CurrentSince Oct 26, 2022 Accepting new patients
Lutheran Medical Group LLC CurrentSince Oct 26, 2022 Accepting new patients
Chattanooga Heart and Rhythm Center Cardiovascular Disease CurrentSince Mar 15, 2017 Accepting new patients
Lima Memorial Joint Operating Company Past Accepting new patients

Locations

2520 E DuPont Rd
Fort Wayne, IN 46825
Phone (219) 407-8000

6920 Pointe Inverness Way
Ste 200
Fort Wayne, IN 46804
Phone (260) 479-3514

7952 W Jefferson Blvd
Fort Wayne, IN 46804
Phone (260) 435-2999

7916 W Jefferson Blvd
Fort Wayne, IN 46804
Phone (260) 432-2298

2512 E DuPont Rd
Ste 110
Fort Wayne, IN 46825
Phone (260) 434-6076

7916 W Jefferson Blvd
#1200
Fort Wayne, IN 46804

2516 E DuPont Rd
Fort Wayne, IN 46825
Phone (260) 434-6076

7910 W Jefferson Blvd
Ste 120
Fort Wayne, IN 46804
Phone (260) 435-7612

7950 W Jefferson Blvd
Fort Wayne, IN 46804
Phone (260) 434-7088

1205 Provident Dr
#A
Warsaw, IN 46580
Phone (574) 269-8383

5726 Marlin Rd
Ste 500
Chattanooga, TN 37411
Phone (423) 682-8100

5751 Uptain Rd
Ste 100
Chattanooga, TN 37411
Phone (423) 855-8406

5243 Little Debbie Pkwy
Ste 111
Ooltewah, TN 37363
Phone (423) 206-2777

Organizations & group practices 4

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 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": "1167782400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723593600000",
    "number": "1134286792",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6920 POINTE INVERNESS WAY STE 200",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468047934",
            "telephone_number": "260-479-3514",
            "fax_number": "260-479-3520"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7916 W JEFFERSON BLVD",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468044140",
            "telephone_number": "260-432-2297",
            "fax_number": "260-479-4602"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COOPER",
        "first_name": "BRIAN",
        "middle_name": "S.",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-03",
        "last_updated": "2024-08-14",
        "certification_date": "2024-08-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Clinical Cardiac Electrophysiology",
            "state": "IN",
            "license": "01088709A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "brian.cooper@lutheranhealthnetwork.cernerdirect.com",
            "affiliation": "N",
            "endpointDescription": "AMR Direct Address",
            "address_1": "7916 W Jefferson Blvd",
            "city": "Fort Wayne",
            "state": "IN",
            "country_code": "US",
            "postal_code": "468044140",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Fort Wayne, IN

Sources for this page

Verify at the official NPI Registry.