Individual provider Active NPI

Brian William Roberts, M.D.

  • Emergency Medicine Physician
  • Camden, NJ
National Provider Identifier
1710202122
Registry record updated Nov 24, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
25MA08889000 Issued in NJ
Practice address
1 Cooper PLZ
Camden, NJ 08103-1461
Phone
(856) 342-2351
NPI assigned
Mar 30, 2010
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 24, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 25MA08889000 NJ Primary
Emergency Medicine Physician 207P00000X MT196382 PA

Addresses

Primary practice location

1 Cooper PLZ
Camden, NJ 08103-1461

Mailing address

1 Cooper PLZ
Camden, NJ 08103-1461
Phone (856) 342-2351

Other identifiers 1

IdentifierTypeStateIssuer
MA08889000OtherNJMEDICAL LICENSE

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
I20110928000514 NJ Practitioner - Emergency Medicine 9032380738 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
91.83 of 100Reported as group
Quality
88.78
Promoting interoperability
99
Improvement activities
40
Cost
74.17

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Quality
89.49
Promoting interoperability
100
Improvement activities
40
Cost
82.75

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MT196382PAMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Cooper Urgent Care, PC CurrentSince Dec 25, 2013 Accepting new patients
CMC Department of Medicine Group PA CurrentSince Jun 16, 2020 Accepting new patients
CMC Department of Medicine Group PA CurrentSince Jun 16, 2020 Accepting new patients
Cooper Univeristy Emergency Physicians, PC Emergency Medicine CurrentSince Feb 20, 2012 Accepting new patients
Cooper University Radiology, PC Past Accepting new patients

Locations

318 S White Horse Pike
Audubon, NJ 08106
Phone (856) 672-6077

1 Cooper Plz
Camden, NJ 08103
Phone (856) 342-2425

3 Cooper Plz
Rm 215
Camden, NJ 08103
Phone (856) 342-2439

1 Federal St
Ste SW200
Camden, NJ 08103
Phone (856) 356-4920

2001 Route 70 W
Cherry Hill, NJ 08002

2001 Route 70 E
Cherry Hill, NJ 08003
Phone (856) 396-6257

175 Route 130 S
Cinnaminson, NJ 08077
Phone (856) 536-1640

310 Salem Woodstown Rd
Salem, NJ 08079
Phone (856) 339-6054

1505 W Sherman Ave
Vineland, NJ 08360
Phone (856) 451-6600

Organizations & group practices 5

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": "1269907200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1416787200000",
    "number": "1710202122",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 COOPER PLZ",
            "city": "CAMDEN",
            "state": "NJ",
            "postal_code": "081031461",
            "telephone_number": "856-342-2351",
            "fax_number": "856-968-8572"
        },
        {
            "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": "856-342-2351"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROBERTS",
        "first_name": "BRIAN",
        "middle_name": "WILLIAM",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-03-30",
        "last_updated": "2014-11-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NJ",
            "license": "25MA08889000",
            "primary": true
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "PA",
            "license": "MT196382",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL LICENSE",
            "identifier": "MA08889000",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Camden, NJ

Sources for this page

Verify at the official NPI Registry.