NPIMap

Organization Active NPI

Cooper Physical Medicine & Rehabilitation Associates, PC

  • Pain Medicine (Physical Medicine & Rehabilitation) Physician
  • Camden, NJ
National Provider Identifier
1508808221
Registry record updated Jul 27, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pain Medicine (Physical Medicine & Rehabilitation) PhysicianTaxonomy code 2081P2900X
Legal business name
COOPER PHYSICAL MEDICINE & REHABILITATION ASSOCIATES, PC
Practice address
1 Cooper PLZ
Camden, NJ 08103-1461
Phone
(856) 342-2040
Fax
(856) 968-8311
NPI assigned
Jun 11, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 27, 2016

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

Authorized official

Name
Anthony J. Mazzarelli, M.D.NPI 1033139407
Title
Chief Medical Office
Phone
(856) 968-7858

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pain Medicine (Physical Medicine & Rehabilitation) PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 2081P2900X
Pain Medicine (Physical Medicine & Rehabilitation) PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 2081P2900X NJ Primary
Physical Therapy Clinic/Center 261QP2000X

Addresses

Primary practice location

1 Cooper PLZ
Camden, NJ 08103-1461

Mailing address

1 Federal Street
SW-200
Camden, NJ 08103-1155
Phone (856) 356-4924

Other identifiers 3

IdentifierTypeStateIssuer
74892OtherAETNA
0194338000OtherAMERIHEALTH
5307708MedicaidNJ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ, PA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040412001131 NJ Part B Supplier - Clinic/Group Practice 4284628330 Receives reassigned benefits from 13 practitioners
Practice locations: Deptford, NJ; Camden, NJ; Elmer, NJ; Glassboro, NJ; Moorestown, NJ; Mullica Hill, NJ; Pennsville, NJ; Sewell, NJ…
O20220510002413 PA Part B Supplier - Clinic/Group Practice 4284628330 Receives reassigned benefits from 1 practitioner
Practice locations: Newtown Square, PA

National Provider Directory

National Provider Directory

Locations

1 Federal St
Fl 2
Camden, NJ 08103
Phone (856) 963-6770

1 Cooper Plz
Ste 550
Camden, NJ 08103
Phone (856) 342-2040

3 Cooper Plz
Rm 100
Camden, NJ 08103
Phone (856) 342-2040

3 Cooper Plz
Rm 511
Camden, NJ 08103
Phone (856) 342-3060

307 Stone Harbor Blvd
Ste 101
Cape May Court House, NJ 08210
Phone (609) 463-2948

1101 Kings Hwy N
Cherry Hill, NJ 08034
Phone (609) 304-5513

1888 Route 70 E
Ste 1
Cherry Hill, NJ 08003
Phone (856) 414-6110

2339 Route 70 W
Fl 2
Cherry Hill, NJ 08002
Phone (856) 532-9519

1450 Almonesson Rd
Deptford, NJ 08096
Phone (856) 537-9600

807 N Haddon Ave
Haddonfield, NJ 08033
Phone (609) 428-2112

218 Sunset Rd
Fl 3
Willingboro, NJ 08046

220 Sunset Rd
Ste 2C
Willingboro, NJ 08046
Phone (609) 871-9500

1511 Clements Bridge Rd
Woodbury, NJ 08096
Phone (856) 513-4124

Practitioners & affiliated clinicians

Practitioners 22

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 22

NPI Registry JSON

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

{
    "created_epoch": "1149984000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1469577600000",
    "number": "1508808221",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 FEDERAL STREET",
            "address_2": "SW-200",
            "city": "CAMDEN",
            "state": "NJ",
            "postal_code": "081031155",
            "telephone_number": "856-356-4924",
            "fax_number": "856-382-6455"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 COOPER PLZ",
            "city": "CAMDEN",
            "state": "NJ",
            "postal_code": "081031461",
            "telephone_number": "856-342-2040",
            "fax_number": "856-968-8311"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COOPER PHYSICAL MEDICINE & REHABILITATION ASSOCIATES, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-11",
        "last_updated": "2016-07-27",
        "status": "A",
        "authorized_official_last_name": "MAZZARELLI",
        "authorized_official_first_name": "ANTHONY",
        "authorized_official_middle_name": "J.",
        "authorized_official_title_or_position": "CHIEF MEDICAL OFFICE",
        "authorized_official_telephone_number": "856-968-7858",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "2081P2900X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Physical Medicine & Rehabilitation, Pain Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2081P2900X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Physical Medicine & Rehabilitation, Pain Medicine",
            "state": "NJ",
            "license": null,
            "primary": true
        },
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "74892",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERIHEALTH",
            "identifier": "0194338000",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5307708",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Camden, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 27, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.