Individual provider Active NPI

Chelsea Cooper, M.D.

  • Dermatology Physician
  • Red Bank, NJ
National Provider Identifier
1407389745
Registry record updated Aug 11, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
25MA11211800 Issued in NJ
Practice address
225 State Route 35 Ste 208
Red Bank, NJ 07701-5919
Phone
(732) 747-5500
Fax
(732) 747-1212
NPI assigned
Apr 4, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 11, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Dermatology Physician 207N00000X 25MA11211800 NJ Primary

Addresses

Primary practice location

225 State Route 35 Ste 208
Red Bank, NJ 07701-5919

Mailing address

225 State Route 35 Ste 208
Red Bank, NJ 07701-5919
Phone (732) 747-5500

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
I20210831000088 NJ Practitioner - Dermatology 5395081053 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Dermatology
Education
Georgetown University School of Medicine, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
The Medical Group of New JerseyGroup PAC ID 4082979166, 299 clinicians
Christopher B. Kruse, M.D., LLCGroup PAC ID 5890849020, 14 clinicians

Practice addresses (Care Compare)

225 State Route 35
Suite 208
Red Bank, NJ 07701-5919
Phone (732) 747-5500

Merit-based Incentive Payment System (MIPS)

Final score
82.52 of 100Reported as group
Quality
73.79
Improvement activities
40
Cost
76.67

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision16
Removal of skin lesions662
Removal or shaving of skin growth11
Skin biopsy476

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
25MA11211800NJMDDermatology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Christopher B. Kruse, M.D., LLC Dermatology CurrentSince Oct 1, 2021 Accepting new patients
The Radiology Group of New Jersey, LLC Past Accepting new patients

Locations

225 State Route 35
Ste 208
Red Bank, NJ 07701
Phone (732) 747-1110

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": "1491264000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1628640000000",
    "number": "1407389745",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "225 STATE ROUTE 35 STE 208",
            "city": "RED BANK",
            "state": "NJ",
            "postal_code": "077015919",
            "telephone_number": "732-747-5500",
            "fax_number": "732-747-1212"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "225 STATE ROUTE 35 STE 208",
            "city": "RED BANK",
            "state": "NJ",
            "postal_code": "077015919",
            "telephone_number": "732-747-5500",
            "fax_number": "732-747-1212"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COOPER",
        "first_name": "CHELSEA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-04-04",
        "last_updated": "2021-08-11",
        "certification_date": "2021-08-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "NJ",
            "license": "25MA11211800",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Red Bank, NJ

Sources for this page

Verify at the official NPI Registry.