Mark S Dannenbaum, MD

Primary specialty

Diagnostic Radiology PhysicianTaxonomy code 2085R0202X

License

25MA05774500 Issued in NJ

Practice address

100 Carnie Blvd
Suite B-5
Voorhees, NJ 08043-4512

Phone

(856) 751-0123

Fax

(856) 751-0535

NPI assigned

Jul 13, 2005

Last updated

May 29, 2012By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 11

Medicare fee-for-service enrollment

Enrolled in NJ, CO2 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

Specialty

Diagnostic Radiology

Education

Other, 1986

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Radiology Associates of Burlington County P aGroup PAC ID 7012954381, 153 clinicians

Larchmont Imaging AssociatesGroup PAC ID 5193762433, 54 clinicians

South Jersey Radiology Associates P aGroup PAC ID 9133115587, 202 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• West Jersey Hospital Hospital, Voorhees, NJ, CCN 310022
• Virtua Mount Holly Hospital Hospital, Mount Holly, NJ, CCN 310057

Merit-based Incentive Payment System (MIPS)

Final score

78.75 of 100Reported as group

Quality

75

Improvement activities

40

Merit-based Incentive Payment System (MIPS)

Final score

83.17 of 100Reported as group

Quality

75

Improvement activities

40

Merit-based Incentive Payment System (MIPS)

Final score

78.75 of 100Reported as group

Quality

75

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Larchmont Imaging Associates

  • Diagnostic Radiology Physician
  • Mount Laurel, NJ
  • NPI 1710932603
  Medicare reassignment Care Compare group NPD
• Radiology Associates of Burlington County P a

  • Diagnostic Radiology Physician
  • Mount Holly, NJ
  • NPI 1255385183

  CO

  Medicare reassignment Care Compare group NPD
• South Jersey Radiology Associates P a

  • Diagnostic Radiology Physician
  • Voorhees, NJ
  • NPI 1477551653

  CO

  Medicare reassignment Care Compare group NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Virtua - Memorial Hospital Burlington County, Inc.

  dba Virtua Mount Holly Hospital

  • General Acute Care Hospital
  • Mount Holly, NJ
  • NPI 1134125016
  Care Compare affiliation
• Virtua - West Jersey Health System, Inc.

  • General Acute Care Hospital
  • Voorhees, NJ
  • NPI 1528064409
  Care Compare affiliation

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

{
    "created_epoch": "1121212800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1338249600000",
    "number": "1336147354",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1710",
            "address_2": "SOUTH JERSEY RADIOLOGY ASSOCIATES, PA",
            "city": "VOORHEES",
            "state": "NJ",
            "postal_code": "080437710",
            "telephone_number": "856-770-0504",
            "fax_number": "856-770-0395"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 CARNIE BLVD",
            "address_2": "SUITE B-5",
            "city": "VOORHEES",
            "state": "NJ",
            "postal_code": "080434512",
            "telephone_number": "856-751-0123",
            "fax_number": "856-751-0535"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DANNENBAUM",
        "first_name": "MARK",
        "middle_name": "S",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-13",
        "last_updated": "2012-05-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "NJ",
            "license": "25MA05774500",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERIHEALTH HMO",
            "identifier": "0553825000",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PREMIER BLUE",
            "identifier": "DA717161",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HORIZON NJ HEALTH",
            "identifier": "1092027",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "0732356",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH",
            "identifier": "10654381",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OXFORD HEALTH",
            "identifier": "A3738029",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HIGHMARK PA BLUE SHIELD",
            "identifier": "DA717161",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "300047103",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5100305",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE",
            "identifier": "1243790",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERIHEALTH PPO",
            "identifier": "717161",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Stephen J Daly, DO
• Kimberly Ann Damian, AGACNP
• Kartik Varma Dandu, M.D.
• Beena M. Daniel, M.D.
• Jeffrey Daniels, M.D.
• Rachel Renae Dantis, CDP
• Nada Daoud
• Amanda Darhun
• David Zalut, MD
• David Zweiback DO

• Diagnostic Radiology Physician in Voorhees, NJ
• Providers in Voorhees, NJ by specialty
• Diagnostic Radiology Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 29, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.