NPIMap

Organization Active NPI

Cooper GYN Oncology Association, PC

  • Gynecologic Oncology Physician
  • Camden, NJ
National Provider Identifier
1831110105
Registry record updated Jul 27, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gynecologic Oncology PhysicianTaxonomy code 207VX0201X
Legal business name
COOPER GYN ONCOLOGY ASSOCIATION, PC
Practice address
3 Cooper PLZ
Suite 104
Camden, NJ 08103-1438
Phone
(856) 342-2186
Fax
(856) 365-1967
NPI assigned
Jul 22, 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.
Title
Chief Medical Office
Phone
(856) 968-7858

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Gynecology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207VG0400X
Gynecologic Oncology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207VX0201X
Gynecologic Oncology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207VX0201X NJ Primary

Addresses

Primary practice location

3 Cooper PLZ
Suite 104
Camden, NJ 08103-1438

Mailing address

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

Other identifiers 1

IdentifierTypeStateIssuer
3071901MedicaidNJ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031124000448 NJ Part B Supplier - Clinic/Group Practice 8729982475 Receives reassigned benefits from 10 practitioners
Practice locations: Mullica Hill, NJ; Willingboro, NJ; Voorhees, NJ; Vineland, NJ; Moorestown, NJ; Egg Harbor Township, NJ; Camden, NJ

National Provider Directory

National Provider Directory

Locations

1900 Mount Holly Rd
Burlington, NJ 08016
Phone (609) 387-0325

1 Cooper Plz
#L
Camden, NJ 08103
Phone (856) 342-2065

3 Cooper Plz
Ste 301A
Camden, NJ 08103
Phone (856) 963-3963

401 Haddon Ave
Camden, NJ 08103
Phone (856) 757-7904

400 W Route 38
Fl 2
Moorestown, NJ 08057
Phone (856) 270-4002

900 Centennial Blvd
Ste M
Voorhees, NJ 08043
Phone (856) 325-6750

Practitioners & affiliated clinicians

Practitioners 34

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 34

NPI Registry JSON

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

{
    "created_epoch": "1153526400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1469577600000",
    "number": "1831110105",
    "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": "3 COOPER PLZ",
            "address_2": "SUITE 104",
            "city": "CAMDEN",
            "state": "NJ",
            "postal_code": "081031438",
            "telephone_number": "856-342-2186",
            "fax_number": "856-365-1967"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COOPER GYN ONCOLOGY ASSOCIATION, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-22",
        "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": "207VG0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Obstetrics & Gynecology, Gynecology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207VX0201X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Obstetrics & Gynecology, Gynecologic Oncology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207VX0201X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Obstetrics & Gynecology, Gynecologic Oncology",
            "state": "NJ",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3071901",
            "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.