Justin Cooper, PHYSICIAN ASSISTANT

Primary specialty

Physician AssistantTaxonomy code 363A00000X

Practice address

333 N Dobson Rd Ste 15
Chandler, AZ 85224-4412

Phone

(480) 282-8336

NPI assigned

May 17, 2019

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in AZ

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

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.

• Siren Medical PC

  • Geriatric Medicine (Family Medicine) Physician
  • Phoenix, AZ
  • NPI 1073148326
  Medicare reassignment
• Tec Emergency Physicians of Arizona, LLC

  • Emergency Care Clinic/Center
  • Gilbert, AZ
  • NPI 1245772870
  Medicare reassignment

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

{
    "created_epoch": "1558051200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1618531200000",
    "number": "1447816152",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "333 N DOBSON RD STE 15",
            "city": "CHANDLER",
            "state": "AZ",
            "postal_code": "852244412",
            "telephone_number": "480-282-8336"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "333 N DOBSON RD STE 15",
            "city": "CHANDLER",
            "state": "AZ",
            "postal_code": "852244412",
            "telephone_number": "480-282-8336"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COOPER",
        "first_name": "JUSTIN",
        "credential": "PHYSICIAN ASSISTANT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-05-17",
        "last_updated": "2021-04-16",
        "certification_date": "2021-04-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "364SA2200X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Adult Health",
            "state": "AZ",
            "license": "7442",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Cooper Medical Group, LLC
• Austin Cooper
• Brett Cooper
• Evelyn Cooper, OTR
• James Thomas Cooper, M.D.
• Kamoni S Cooper, P.T.
• Tanya Marie Schulz Cooper, LMT
• Tracey Lynn Cooper, FNP-BC
• Hannah Copeland, MD
• James W Copley

• Physician Assistant in Chandler, AZ
• Providers in Chandler, AZ by specialty
• Physician Assistant in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 16, 2021; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.