Individual provider Active NPI

Kyle Gleaves, MD

  • Internal Medicine Physician
  • Cherry Hill, NJ
National Provider Identifier
1144714049
Registry record updated Nov 12, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
25MA11134200 Issued in NJ
Practice address
1103 Kings Hwy N Ste 203
Cherry Hill, NJ 08034-1983
Phone
(185) 632-1191
NPI assigned
Jun 14, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 12, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 25MA11134200 NJ Primary

Addresses

Primary practice location

1103 Kings Hwy N Ste 203
Cherry Hill, NJ 08034-1983

Mailing address

1 Federal St # 200
Camden, NJ 08103-1088
Phone (856) 356-4924

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
I20210830002231 NJ Practitioner - Internal Medicine 2365771045 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Cooper Family Medicine PCGroup PAC ID 4284530197, 117 clinicians

Practice addresses (Care Compare)

2339 Route 70 W
Cherry Hill, NJ 08002-3315
Phone (800) 826-6737

3 Cooper PLZ
Camden, NJ 08103-1438

504 White Horse Pike
Haddon Heights, NJ 08035-1709
Phone (856) 546-7990

Hospital & facility affiliations

  • Bayada Home Health Care, Inc Home health agency, Pennsauken, NJ, CCN 317065
  • Cooper University Hospital Hospital, Camden, NJ, CCN 310014

Merit-based Incentive Payment System (MIPS)

Final score
99.52 of 100Reported as apm
Quality
81.58
Promoting interoperability
99.4
Improvement activities
40

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Cooper Family Medicine, PC CurrentSince Jul 11, 2021 Accepting new patients
Cooper Family Medicine PC CurrentSince Jul 11, 2021 Accepting new patients

Locations

1 Federal St
Ste SW200
Camden, NJ 08103
Phone (856) 356-4920

1103 Kings Hwy N
Ste 203
Cherry Hill, NJ 08034
Phone (856) 321-1919

504 White Horse Pike
Haddon Hgts, NJ 08035
Phone (856) 546-7990

1001 Lincoln Dr W
Ste F
Marlton, NJ 08053
Phone (609) 810-1800

Interoperability endpoints

  • Direct secure messaging: kgleaves115094@direct.cooperhealth.edu

Organizations & group practices 2

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 6

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": "1528934400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1636675200000",
    "number": "1144714049",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 FEDERAL ST # 200",
            "city": "CAMDEN",
            "state": "NJ",
            "postal_code": "081031088",
            "telephone_number": "856-356-4924"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1103 KINGS HWY N STE 203",
            "city": "CHERRY HILL",
            "state": "NJ",
            "postal_code": "080341983",
            "telephone_number": "185-632-1191"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GLEAVES",
        "first_name": "KYLE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-06-14",
        "last_updated": "2021-11-12",
        "certification_date": "2021-11-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NJ",
            "license": "25MA11134200",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cherry Hill, NJ

Sources for this page

Verify at the official NPI Registry.