Individual provider Active NPI

Brianna Azadeh Yates, MD

  • Family Medicine Physician
  • Mount Laurel, NJ
National Provider Identifier
1780264697
Registry record updated Aug 28, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
25MA12317800 Issued in NJ
Practice address
2963 Marne Hwy
Mount Laurel, NJ 08054-2036
Phone
(856) 638-1990
NPI assigned
Apr 13, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 28, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 25MA12317800 NJ Primary

Addresses

Primary practice location

2963 Marne Hwy
Mount Laurel, NJ 08054-2036

Mailing address

1 Federal St Ste 200
Camden, NJ 08103-1088
Phone (848) 288-6935

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
I20240722000669 NJ Practitioner - Family Practice 3173924743 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Cooper Medical School of Rowan University, 2021
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)

2963 Marne Hwy
Mount Laurel, NJ 08054-2036
Phone (856) 638-1990

Hospital & facility affiliations

  • Cooper University Hospital Hospital, Camden, NJ, CCN 310014
  • Virtua Mount Holly Hospital Hospital, Mount Holly, NJ, CCN 310057

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

Practice roles

OrganizationSpecialtyStatusNew patients
Cooper Family Medicine, PC Family Medicine CurrentSince Jul 10, 2024 Accepting new patients
Cooper Family Medicine PC Family Medicine CurrentSince Jul 10, 2024 Accepting new patients

Locations

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

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

Interoperability endpoints

  • Direct secure messaging: byates70371@direct.cooperhealth.edu

Organizations & group practices 2

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 3

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": "1618272000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724803200000",
    "number": "1780264697",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 FEDERAL ST STE 200",
            "city": "CAMDEN",
            "state": "NJ",
            "postal_code": "081031088",
            "telephone_number": "848-288-6935",
            "fax_number": "732-790-0107"
        },
        {
            "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": [],
    "basic": {
        "last_name": "YATES",
        "first_name": "BRIANNA",
        "middle_name": "AZADEH",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-04-13",
        "last_updated": "2024-08-28",
        "certification_date": "2024-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NJ",
            "license": "25MA12317800",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mount Laurel, NJ

Sources for this page

Verify at the official NPI Registry.