Individual provider Active NPI

Tara Jennings, MD

  • Procedural Dermatology Physician
  • Camden, NJ
National Provider Identifier
1932661287
Registry record updated Aug 28, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Procedural Dermatology PhysicianTaxonomy code 207NS0135X
License
25MA11955300 Issued in NJ
Practice address
2 Cooper PLZ
Camden, NJ 08103-1461
Phone
(855) 632-2667
NPI assigned
Apr 4, 2019
Last updated
Aug 28, 2024By the provider in NPPES
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
Procedural Dermatology Physician 207NS0135X 25MA11955300 NJ Primary

Addresses

Primary practice location

2 Cooper PLZ
Camden, NJ 08103-1461

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
I20240816001665 NJ Practitioner - Dermatology 6305173402 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Dermatology
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1000 Sagemore Dr
Suite 10103 Ctr Drmtlgc Srgy
Marlton, NJ 08053-4301
Phone (856) 596-3040

Hospital & facility affiliations

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

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision74
Removal of tissue1-10
Removal of skin lesions19
Removal of skin cancer370
Removal of nail tissue1-10
Skin biopsy82

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
25MA11955300NJMDProcedural Dermatology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
CMC Department of Medicine CurrentSince Jul 2, 2024 Accepting new patients
CMC Department of Medicine Group PA CurrentSince Jul 2, 2024 Accepting new patients
Cooper Surgical Associates, PA Past Accepting new patients

Locations

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

2 Cooper Plz
Camden, NJ 08103
Phone (609) 342-7600

2 Cooper Plz
Ste 200
Camden, NJ 08103

3 Cooper Plz
Rm 211
Camden, NJ 08103
Phone (856) 342-2544

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

3 Cooper Plz
Rm 311
Camden, NJ 08103
Phone (856) 342-2034

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 2

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": "1554336000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724803200000",
    "number": "1932661287",
    "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": "2 COOPER PLZ",
            "city": "CAMDEN",
            "state": "NJ",
            "postal_code": "081031461",
            "telephone_number": "855-632-2667"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JENNINGS",
        "first_name": "TARA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-04-04",
        "last_updated": "2024-08-28",
        "certification_date": "2024-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207NS0135X",
            "taxonomy_group": "",
            "desc": "Dermatology, Procedural Dermatology",
            "state": "NJ",
            "license": "25MA11955300",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Camden, NJ

Sources for this page

Verify at the official NPI Registry.