NPIMap

Organization Active NPI

Cooper Pediatric Specialists, PC

  • Pediatrics Physician
  • Camden, NJ
National Provider Identifier
1306867585
Registry record updated Jul 28, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
Legal business name
COOPER PEDIATRIC SPECIALISTS, PC
Practice address
3 Cooper PLZ
Suite 200
Camden, NJ 08103-1438
Phone
(856) 342-2001
Fax
(856) 968-2499
NPI assigned
Jul 22, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 28, 2016

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

Authorized official

Name
Anthony J. Mazzarelli, M.D.
Title
Chief Medical Office
Phone
(856) 968-7858

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208000000X
Pediatrics PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208000000X NJ Primary

Addresses

Primary practice location

3 Cooper PLZ
Suite 200
Camden, NJ 08103-1438

Mailing address

1 Federal Street
SW-200
Camden, NJ 08103-1155
Phone (856) 356-4924

Other identifiers 1

IdentifierTypeStateIssuer
9024603MedicaidNJ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080708000593 NJ Part B Supplier - Clinic/Group Practice 9335211317 Receives reassigned benefits from 139 practitioners
Practice locations: Voorhees, NJ; Woodbury, NJ; Sewell, NJ; Pennsville, NJ; Moorestown, NJ; Cape May Court House, NJ; Burlington, NJ; Camden, NJ

National Provider Directory

National Provider Directory

Locations

1900 Mount Holly Rd
Ste 541
Burlington, NJ 08016

1900 Mount Holly Rd
Bldg 1
Burlington, NJ 08016

1900 Burlington Mount Holly Rd
Ste 4A
Burlington Township, NJ 08016

3 Cooper Plz
Rm 309
Camden, NJ 08103
Phone (856) 342-2226

1 Cooper Plz
Fl 7
Camden, NJ 08103
Phone (856) 342-2265

1 Cooper Plz
Bldg 7TH
Camden, NJ 08103

1 Cooper Plz
#2B
Camden, NJ 08103
Phone (856) 342-2600

3 Cooper Plz
Rm 520
Camden, NJ 08103
Phone (856) 342-2298

333 E Jimmie Leeds Rd
Ste 8
Galloway, NJ 08205

542 Lippincott Dr
Marlton, NJ 08053
Phone (856) 596-3393

330 Woodstown Rd
Ste 7
Salem, NJ 08079
Phone (856) 342-2617

2 Plaza Dr
Ste 202
Sewell, NJ 08080
Phone (856) 270-4100

2566 Nottingham Way
Trenton, NJ 08619
Phone (609) 587-3041

303 Central Ave Unit B
Brooklyn, NY 11221

Practitioners & affiliated clinicians

Practitioners 199

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 199

NPI Registry JSON

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

{
    "created_epoch": "1153526400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1469664000000",
    "number": "1306867585",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 FEDERAL STREET",
            "address_2": "SW-200",
            "city": "CAMDEN",
            "state": "NJ",
            "postal_code": "081031155",
            "telephone_number": "856-356-4924",
            "fax_number": "856-382-6455"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3 COOPER PLZ",
            "address_2": "SUITE 200",
            "city": "CAMDEN",
            "state": "NJ",
            "postal_code": "081031438",
            "telephone_number": "856-342-2001",
            "fax_number": "856-968-2499"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COOPER PEDIATRIC SPECIALISTS, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-22",
        "last_updated": "2016-07-28",
        "status": "A",
        "authorized_official_last_name": "MAZZARELLI",
        "authorized_official_first_name": "ANTHONY",
        "authorized_official_middle_name": "J.",
        "authorized_official_title_or_position": "CHIEF MEDICAL OFFICE",
        "authorized_official_telephone_number": "856-968-7858",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics",
            "state": "NJ",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9024603",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Camden, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 28, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.