Individual provider Active NPI

Charles Randall Cooper, MD

  • Surgery Physician
  • Berkeley Heights, NJ
National Provider Identifier
1235557695
Registry record updated Feb 16, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
25MA11047800 Issued in NJ
Practice address
1 Diamond Hill Rd
Berkeley Heights, NJ 07922-2104
Phone
(908) 273-4300
NPI assigned
Apr 2, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 16, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Colon & Rectal Surgery Physician 208C00000X 25MA11047800 NJ
Surgery Physician 208600000X 25MA11047800 NJ Primary

Addresses

Primary practice location

1 Diamond Hill Rd
Berkeley Heights, NJ 07922-2104

Mailing address

1 Diamond Hill Rd
Berkeley Heights, NJ 07922-2104

Other practice location 1

177 Ft Washingtn Ave
7GS-313
New York, NY 10032-3733
Phone (212) 305-3038

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
I20211020000893 NJ Practitioner - Colorectal Surgery (Proctology) 9931445657 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Colorectal Surgery (Proctology)
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Summit Medical Group PAGroup PAC ID 5395642276, 1,204 clinicians

Practice addresses (Care Compare)

1 Diamond Hill Rd
Berkeley Heights, NJ 07922-2104
Phone (908) 273-4300

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy17
Hernia repair - groin (open)1-10
Hernia repair (minimally invasive)1-10
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
25MA11047800NJMDColon & Rectal Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Summit Medical Group PA CurrentSince Sep 13, 2021 Accepting new patients
Summit Medical Group PA CurrentSince Sep 13, 2021 Accepting new patients
Summit Medical Group, Inc Surgery Past Accepting new patients

Locations

1 Diamond Hill Rd
Berkeley Heights, NJ 07922
Phone (908) 277-8868

1 Seymour St
Montclair, NJ 07042
Phone (973) 302-6025

150 Floral Ave
New Providence, NJ 07974
Phone (908) 588-3890

Interoperability endpoints

  • Direct secure messaging: charles.cooper.1@2983.direct.athenahealth.com
  • Direct secure messaging: ccooper462865@ahs.direct-ci.com
  • Direct secure messaging: ccooper252356@epicdirect.rwjbh.org

Organizations & group practices 3

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 4

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": "1396396800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1771200000000",
    "number": "1235557695",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 DIAMOND HILL RD",
            "city": "BERKELEY HEIGHTS",
            "state": "NJ",
            "postal_code": "079222104"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 DIAMOND HILL RD",
            "city": "BERKELEY HEIGHTS",
            "state": "NJ",
            "postal_code": "079222104",
            "telephone_number": "908-273-4300"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "177 Ft Washingtn Ave",
            "address_2": "7GS-313",
            "address_purpose": "LOCATION",
            "city": "New York",
            "state": "NY",
            "postal_code": "100323733",
            "country_code": "US",
            "telephone_number": "212-305-3038",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "COOPER",
        "first_name": "CHARLES",
        "middle_name": "RANDALL",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-04-02",
        "last_updated": "2026-02-16",
        "certification_date": "2026-02-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208C00000X",
            "taxonomy_group": "",
            "desc": "Colon & Rectal Surgery",
            "state": "NJ",
            "license": "25MA11047800",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "NJ",
            "license": "25MA11047800",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Berkeley Heights, NJ

Sources for this page

Verify at the official NPI Registry.