Individual provider Active NPI

David Bromberg, M.D.

  • Otolaryngology/Facial Plastic Surgery Physician
  • Sewell, NJ
National Provider Identifier
1376586412
Registry record updated Aug 26, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology/Facial Plastic Surgery PhysicianTaxonomy code 207YX0905X
License
32161 Issued in NJ
Practice address
292 Hurffville Grenloch Rd
Suite 100
Sewell, NJ 08080-2656
Phone
(856) 589-9200
Fax
(856) 589-1437
NPI assigned
Jun 14, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 26, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology/Facial Plastic Surgery Physician 207YX0905X 32161 NJ Primary

Addresses

Primary practice location

292 Hurffville Grenloch Rd
Suite 100
Sewell, NJ 08080-2656

Mailing address

292 Hurffville Grenloch Rd
Suite 100
Sewell, NJ 08080-2656
Phone (856) 589-9200

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
I20101005000464 NJ Practitioner - Otolaryngology 3173715455 Reassigns benefits to 1 organization
Practice locations: Sewell, NJ

Care Compare profile

Medicare Care Compare
Specialty
Otolaryngology
Education
Temple University School of Medicine, 1972
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cooper Surgical Associates, PAGroup PAC ID 3274430764, 303 clinicians

Practice addresses (Care Compare)

1 Cooper PLZ
Camden, NJ 08103-1461
Phone (856) 342-2000

Merit-based Incentive Payment System (MIPS)

Final score
85.23 of 100Reported as group
Quality
77.64
Promoting interoperability
98
Improvement activities
40
Cost
68.41

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
32161NJMDOtolaryngology/Facial Plastic Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Cooper Surgical Associates, PA CurrentSince Jan 16, 2021 Accepting new patients
Cooper Surgical Associates, PA CurrentSince Jan 16, 2021 Accepting new patients

Locations

3 Cooper Plz
Rm 411
Camden, NJ 08103
Phone (856) 342-2270

1 Cooper Plz
Camden, NJ 08103
Phone (856) 342-2425

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

Interoperability endpoints

  • Direct secure messaging: dbromberg108962@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.

NPI Registry JSON

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

{
    "created_epoch": "1150243200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1219708800000",
    "number": "1376586412",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "292 HURFFVILLE GRENLOCH RD",
            "address_2": "SUITE 100",
            "city": "SEWELL",
            "state": "NJ",
            "postal_code": "080802656",
            "telephone_number": "856-589-9200",
            "fax_number": "856-589-1437"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "292 HURFFVILLE GRENLOCH RD",
            "address_2": "SUITE 100",
            "city": "SEWELL",
            "state": "NJ",
            "postal_code": "080802656",
            "telephone_number": "856-589-9200",
            "fax_number": "856-589-1437"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROMBERG",
        "first_name": "DAVID",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-14",
        "last_updated": "2008-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207YX0905X",
            "taxonomy_group": "",
            "desc": "Otolaryngology, Otolaryngology/Facial Plastic Surgery",
            "state": "NJ",
            "license": "32161",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sewell, NJ

Sources for this page

Verify at the official NPI Registry.