Individual provider Active NPI

Brian Michael McGovern, SC.D

  • Audiologist
  • Camden, NJ
National Provider Identifier
1942586862
Registry record updated Oct 11, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
AudiologistTaxonomy code 231H00000X
License
41YA00080700 Issued in NJ
Practice address
3 Cooper PLZ RM 511
Camden, NJ 08103-1407
Phone
(856) 342-3060
Fax
(856) 968-8358
NPI assigned
Oct 24, 2011
Last updated
Oct 11, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 11, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Audiologist 231H00000X 41YA00080700 NJ Primary

Addresses

Primary practice location

3 Cooper PLZ RM 511
Camden, NJ 08103-1407

Mailing address

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

Other practice location 1

177 N Dean St
Englewood, NJ 07631-2533
Phone (201) 567-2771

Other practice location 2

6200 Main St
Voorhees, NJ 08043-4629
Phone (856) 325-6516

Other practice location 3

2 Plaza Dr Ste 202
Sewell, NJ 08080-9207
Phone (856) 270-4150

Other identifiers 1

IdentifierTypeStateIssuer
41YA00080700OtherNJNJ ATTORNEY GENERAL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ, PA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20111229000185 NJ Practitioner - Qualified Audiologist 6709052533 Reassigns benefits to 1 organization
I20160421002219 PA Practitioner - Qualified Audiologist 6709052533

Care Compare profile

Medicare Care Compare
Specialty
Qualified Audiologist
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cooper Surgical Associates, PAGroup PAC ID 3274430764, 303 clinicians

Practice addresses (Care Compare)

6200 Main St
Voorhees, NJ 08043-4629
Phone (856) 325-6717

Merit-based Incentive Payment System (MIPS)

Final score
85.23 of 100Reported as group
Quality
77.64
Promoting interoperability
98
Improvement activities
40
Cost
68.41

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
41YA00080700NJMDAudiologist

Practice roles

OrganizationSpecialtyStatusNew patients
Cooper Surgical Associates, PA CurrentSince Jun 5, 2023 Accepting new patients
Cooper Surgical Associates, PA CurrentSince Jun 5, 2023 Accepting new patients
Robert T Sataloff, MD and Assoc, LLC CurrentSince Mar 31, 2016 Accepting new patients
Cooper Physical Medicine & Rehabilitation Associates, PC PastSince Oct 15, 2023 Accepting new patients
North Jersey Otolaryngology-Head and Neck Surgery,PA Past Accepting new patients

Locations

3 Cooper Plz
Rm 411
Camden, NJ 08103
Phone (856) 342-2270

3 Cooper Plz
Rm 511
Camden, NJ 08103
Phone (856) 342-3060

2 Plaza Dr
Ste 202
Sewell, NJ 08080
Phone (856) 270-4100

6200 Main St
Voorhees, NJ 08043
Phone (856) 325-6516

219 N Broad St
Fl 10
Philadelphia, PA 19107
Phone (215) 762-5530

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1319414400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1696982400000",
    "number": "1942586862",
    "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"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3 COOPER PLZ RM 511",
            "city": "CAMDEN",
            "state": "NJ",
            "postal_code": "081031407",
            "telephone_number": "856-342-3060",
            "fax_number": "856-968-8358"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "177 N Dean St",
            "address_purpose": "LOCATION",
            "city": "Englewood",
            "state": "NJ",
            "postal_code": "076312533",
            "country_code": "US",
            "telephone_number": "201-567-2771",
            "fax_number": "201-567-5052",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "6200 Main St",
            "address_purpose": "LOCATION",
            "city": "Voorhees",
            "state": "NJ",
            "postal_code": "080434629",
            "country_code": "US",
            "telephone_number": "856-325-6516",
            "fax_number": "856-325-6690",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2 Plaza Dr Ste 202",
            "address_purpose": "LOCATION",
            "city": "Sewell",
            "state": "NJ",
            "postal_code": "080809207",
            "country_code": "US",
            "telephone_number": "856-270-4150",
            "fax_number": "856-270-4012",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MCGOVERN",
        "first_name": "BRIAN",
        "middle_name": "MICHAEL",
        "credential": "SC.D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-10-24",
        "last_updated": "2023-10-11",
        "certification_date": "2023-10-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "NJ",
            "license": "41YA00080700",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NJ ATTORNEY GENERAL",
            "identifier": "41YA00080700",
            "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 Oct 11, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.