Individual provider Active NPI

M Brett Cooper, M.D.

  • Pediatric Adolescent Medicine Physician
  • Dallas, TX
National Provider Identifier
1477819241
Registry record updated Aug 7, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Adolescent Medicine PhysicianTaxonomy code 2080A0000X
License
Q4928 Issued in TX
Practice address
5323 Harry Hines Boulevard
Dallas, TX 75390
Phone
(214) 648-5079
NPI assigned
Apr 6, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 7, 2018

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X Q4928 TX
Developmental - Behavioral Pediatrics Physician 2080P0006X Q4928 TX
Pediatric Adolescent Medicine Physician 2080A0000X Q4928 TX Primary

Addresses

Primary practice location

5323 Harry Hines Boulevard
Dallas, TX 75390

Mailing address

PO Box 845347
Dallas, TX 75284-5347
Phone (214) 648-5079

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20181002000203 TX Practitioner - Pediatric Medicine 3173874138 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
82.87 of 100Reported as group
Quality
70.15
Promoting interoperability
100
Improvement activities
40
Cost
72.75

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
Q4928TXMDPediatric Adolescent Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University of Texas Southwestern Medical Center at Dallas Current Accepting new patients
The University of Texas Southwestern Medical Center at Dallas CurrentSince Sep 12, 2018 Accepting new patients
University of Texas Southwestern Medical Center at Dallas Pediatrics CurrentSince Sep 12, 2018 Accepting new patients
Lima Memorial Joint Operating Company Past Accepting new patients

Locations

2222 Welborn St
Dallas, TX 75219
Phone (214) 559-5000

1935 Medical District Dr
Dallas, TX 75235
Phone (214) 456-2735

420 E 6th St
Ste 202
Odessa, TX 79761
Phone (214) 648-9618

7601 Preston Rd
Plano, TX 75024
Phone (469) 303-7300

5323 Harry Hines Blvd
Ut Southwest Medical Center, TX 75390

Organizations & group practices 4

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": "1333670400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1533600000000",
    "number": "1477819241",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 845347",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752845347",
            "telephone_number": "214-648-5079"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5323 HARRY HINES BOULEVARD",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "75390",
            "telephone_number": "214-648-5079"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COOPER",
        "first_name": "M BRETT",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-04-06",
        "last_updated": "2018-08-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "TX",
            "license": "Q4928",
            "primary": false
        },
        {
            "code": "2080P0006X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Developmental - Behavioral Pediatrics",
            "state": "TX",
            "license": "Q4928",
            "primary": false
        },
        {
            "code": "2080A0000X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Adolescent Medicine",
            "state": "TX",
            "license": "Q4928",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dallas, TX

Sources for this page

Verify at the official NPI Registry.