Individual provider Active NPI

Ann Leilani Fahey, MD

  • Plastic Surgery Physician
  • Camden, NJ
National Provider Identifier
1386737997
Registry record updated Apr 25, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Plastic Surgery PhysicianTaxonomy code 208200000X
License
MA62096 Issued in NJ
Practice address
3 Cooper PLZ
Suite 411
Camden, NJ 08103-1438
Phone
(856) 342-3114
Fax
(856) 541-5379
NPI assigned
Oct 2, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 25, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Plastic Surgery Physician 208200000X MA62096 NJ Primary
Plastic Surgery Physician 208200000X MD069186L PA

Addresses

Primary practice location

3 Cooper PLZ
Suite 411
Camden, NJ 08103-1438

Mailing address

3 Cooper PLZ
Suite 502
Camden, NJ 08103-1438
Phone (856) 968-7433

Other identifiers 14

IdentifierTypeStateIssuer
2042706OtherNJCIGNA
24357OtherNJUNIVERISTY HEALTH PLAN
438669OtherNJAP BS HIGHMARK
CA0000364 01OtherNJAMERICHOICE
P1911543OtherNJOXFORD
240006442OtherNJRR MEDICARE
0658970000OtherNJAMERIHEALTH/KEYSTONE/IBC
1944936OtherNJUNITED HEALTHCARE
2230968OtherNJAETNA
3K6089OtherNJHEALTHNET
438669OtherNJAMERIHEALTH PPO/IBC/ PA BS
8025304OtherNYNY MEDICAID
1098414OtherNJHORIZON NJ HEALTH
8025304MedicaidNJ

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
I20050623000644 NJ Practitioner - Plastic and Reconstructive Surgery 7719922384 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Plastic and Reconstructive Surgery
Education
JS Weill Medical College, Cornell University, 1988
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

2 Cooper PLZ
Camden, NJ 08103-1461

3 Cooper PLZ
Camden, NJ 08103-1438

715 Fellowship Rd
Mount Laurel, NJ 08054-1052
Phone (800) 826-6737

900 Centennial Blvd
Voorhees, NJ 08043-4637

Hospital & facility affiliations

  • Cooper University Hospital Hospital, Camden, NJ, CCN 310014

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

Procedures performed for Medicare patients

ProcedureNumber of procedures
Mastectomy22
Melanoma (skin cancer) excision11
Removal of tissue1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MA62096NJMDPlastic Surgery Physician
MD069186LPAMDPlastic Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Cooper Surgical Associates, PA CurrentSince Aug 29, 2012 Accepting new patients
Cooper Surgical Associates, PA Plastic Surgery CurrentSince Aug 29, 2012 Accepting new patients

Locations

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

3 Cooper Plz
Rm 104
Camden, NJ 08103
Phone (609) 963-6770

2 Cooper Plz
Camden, NJ 08103
Phone (609) 342-7600

3 Cooper Plz
Rm 502
Camden, NJ 08103
Phone (856) 342-2921

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

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

3 Cooper Plz
Rm 403
Camden, NJ 08103
Phone (856) 342-2439

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

6200 Main St
Voorhees, NJ 08043
Phone (856) 325-6516

Interoperability endpoints

  • Direct secure messaging: afahey2790@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 2

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": "1159747200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1461542400000",
    "number": "1386737997",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3 COOPER PLZ",
            "address_2": "SUITE 502",
            "city": "CAMDEN",
            "state": "NJ",
            "postal_code": "081031438",
            "telephone_number": "856-968-7433"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3 COOPER PLZ",
            "address_2": "SUITE 411",
            "city": "CAMDEN",
            "state": "NJ",
            "postal_code": "081031438",
            "telephone_number": "856-342-3114",
            "fax_number": "856-541-5379"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FAHEY",
        "first_name": "ANN",
        "middle_name": "LEILANI",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-02",
        "last_updated": "2016-04-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208200000X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery",
            "state": "NJ",
            "license": "MA62096",
            "primary": true
        },
        {
            "code": "208200000X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery",
            "state": "PA",
            "license": "MD069186L",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "2042706",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNIVERISTY HEALTH PLAN",
            "identifier": "24357",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AP BS HIGHMARK",
            "identifier": "438669",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERICHOICE",
            "identifier": "CA0000364 01",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OXFORD",
            "identifier": "P1911543",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "240006442",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERIHEALTH/KEYSTONE/IBC",
            "identifier": "0658970000",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE",
            "identifier": "1944936",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "2230968",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHNET",
            "identifier": "3K6089",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERIHEALTH PPO/IBC/ PA BS",
            "identifier": "438669",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NY MEDICAID",
            "identifier": "8025304",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HORIZON NJ HEALTH",
            "identifier": "1098414",
            "state": "NJ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8025304",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Camden, NJ

Sources for this page

Verify at the official NPI Registry.