NPIMap

Individual provider Active NPI

Lara A Bruneau, M.D.

  • Internal Medicine Physician
  • Mount Laurel, NJ
National Provider Identifier
1669410445
Registry record updated May 11, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
25MA06431100 Issued in NJ
Practice address
2963 Marne Hwy
Mount Laurel, NJ 08054-2036
Phone
(856) 638-1990
NPI assigned
Jun 3, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 11, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 25MA06431100 NJ Primary

Addresses

Primary practice location

2963 Marne Hwy
Mount Laurel, NJ 08054-2036

Mailing address

1 Federal St # 200
Camden, NJ 08103-1088
Phone (856) 356-4924

Other practice location 1

110 Marter Ave
St 408
Moorestown, NJ 08057-3124
Phone (856) 638-1990

Other identifiers 1

IdentifierTypeStateIssuer
8712701MedicaidNJ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040126000288 NJ Practitioner - Pediatric MedicinePractitioner - Internal Medicine 7719889195 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pediatric MedicineAlso: Internal Medicine
Education
Rutgers New Jersey Medical School, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Cooper Family Medicine PCGroup PAC ID 4284530197, 117 clinicians

Practice addresses (Care Compare)

6 Earlin Ave
Suite 240
Browns Mills, NJ 08015-1768
Phone (609) 303-4560

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
99.52 of 100Reported as apm
Quality
81.58
Promoting interoperability
99.4
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
25MA06431100NJMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Cooper Family Medicine, PC CurrentSince Nov 24, 2024 Accepting new patients

Locations

6 Earlin Ave
Ste 240
Browns Mills, NJ 08015
Phone (609) 303-4560

639 Cooper St
#B12
Camden, NJ 08102
Phone (856) 614-5603

1865 Harrison Ave
Ste 1300
Camden, NJ 08105
Phone (856) 963-0126

3156 River Rd
Camden, NJ 08105
Phone (856) 356-4988

504 White Horse Pike
Haddon Hgts, NJ 08035
Phone (856) 546-7990

1001 Lincoln Dr W
Ste F
Marlton, NJ 08053
Phone (609) 810-1800

110 Marter Ave
Ste 408
Moorestown, NJ 08057
Phone (856) 231-0590

2963 Marne Hwy
Mount Laurel, NJ 08054
Phone (856) 638-1990

Interoperability endpoints

  • Direct secure messaging: lbruneau5330@direct.cooperhealth.edu

Organizations & group practices 1

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 10

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": "1149292800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1589155200000",
    "number": "1669410445",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 FEDERAL ST # 200",
            "city": "CAMDEN",
            "state": "NJ",
            "postal_code": "081031088",
            "telephone_number": "856-356-4924"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2963 MARNE HWY",
            "city": "MOUNT LAUREL",
            "state": "NJ",
            "postal_code": "080542036",
            "telephone_number": "856-638-1990"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "110 Marter Ave",
            "address_2": "ST 408",
            "address_purpose": "LOCATION",
            "city": "Moorestown",
            "state": "NJ",
            "postal_code": "080573124",
            "country_code": "US",
            "telephone_number": "856-638-1990",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BRUNEAU",
        "first_name": "LARA",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-03",
        "last_updated": "2020-05-11",
        "certification_date": "2020-05-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NJ",
            "license": "25MA06431100",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8712701",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mount Laurel, NJ

Sources for this page

Verify at the official NPI Registry.