Active NPI
Jeffrey Charles Oppenheim, BA, MMS, MD
- Family Medicine Physician
- Mount Laurel, NJ
National Provider Identifier
1952302259
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 25MA3216900
- Practice address
- 100 Century Pkwy
Suite 140
Mount Laurel, NJ 08054-1149 - Phone
- (856) 380-2400
- Fax
- (856) 234-7870
- NPI assigned
- Aug 9, 2005
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 25MA3216900 | NJ | Primary |
Addresses
Primary practice location
100 Century Pkwy
Suite 140
Mount Laurel, NJ 08054-1149
Mailing address
100 Century Pkwy
Suite 140
Mount Laurel, NJ 08054-1149
Phone (856) 380-2400
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1244108 | Medicaid | NJ |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Bachelor of Arts, Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 25MA3216900 | NJ | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Rowansom Dept of Pediatrics | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Pediatrics Physician
- Sewell, NJ
- NPI 1275503203
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1123545600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1446422400000",
"number": "1952302259",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "100 CENTURY PKWY",
"address_2": "SUITE 140",
"city": "MOUNT LAUREL",
"state": "NJ",
"postal_code": "080541149",
"telephone_number": "856-380-2400",
"fax_number": "856-234-7870"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "100 CENTURY PKWY",
"address_2": "SUITE 140",
"city": "MOUNT LAUREL",
"state": "NJ",
"postal_code": "080541149",
"telephone_number": "856-380-2400",
"fax_number": "856-234-7870"
}
],
"practiceLocations": [],
"basic": {
"last_name": "OPPENHEIM",
"first_name": "JEFFREY",
"middle_name": "CHARLES",
"name_prefix": "Dr.",
"credential": "BA, MMS, MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-08-09",
"last_updated": "2015-11-02",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "NJ",
"license": "25MA3216900",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1244108",
"state": "NJ"
}
],
"endpoints": [],
"other_names": []
}Other providers in Mount Laurel, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 2, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.