Individual provider Active NPI

Brooke M. Convento, CRNA

  • Certified Registered Nurse Anesthetist
  • Marlton, NJ
National Provider Identifier
1992057145
Registry record updated Oct 12, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
26NR14882000 Issued in NJ
Practice address
102 Centre Blvd Ste E
Marlton, NJ 08053-4129
Phone
(856) 988-6260
Fax
(856) 988-6270
NPI assigned
Oct 12, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 12, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 26NR14882000 NJ Primary

Addresses

Primary practice location

102 Centre Blvd Ste E
Marlton, NJ 08053-4129

Mailing address

102 Centre Blvd Ste E
Marlton, NJ 08053-4129
Phone (856) 988-6260

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130520000024 NJ Practitioner - Certified Registered Nurse Anesthetist (Crna) 8022255660 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1000 White Horse Rd
Suite 204
Voorhees, NJ 08043-4408

Hospital & facility affiliations

  • Cooper University Hospital Hospital, Camden, NJ, CCN 310014

Merit-based Incentive Payment System (MIPS)

Final score
87.96 of 100Reported as group
Quality
73.04
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
26NR14882000NJMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
West Jersey Anesthesia Associate PA CurrentSince Mar 30, 2013 Accepting new patients
Cooper Anesthesia Associates, PC CurrentSince Mar 6, 2023 Accepting new patients
Capstone Behavioral Health L.L.C. PastSince Aug 25, 2019 Accepting new patients

Locations

1 Cooper Plz
Camden, NJ 08103
Phone (856) 342-2425

2 Stone Harbor Blvd
Cape May Court House, NJ 08210
Phone (609) 463-2000

102 Centre Blvd
Ste E
Marlton, NJ 08053
Phone (856) 462-6400

501 Fellowship Rd
Ste 102
Mount Laurel, NJ 08054
Phone (856) 380-1768

100 Bowman Dr
Voorhees, NJ 08043
Phone (856) 247-3000

1000 White Horse Rd
Ste 204
Voorhees, NJ 08043
Phone (856) 309-5808

900 Centennial Blvd
Ste E
Voorhees, NJ 08043
Phone (856) 325-6505

200 Bowman Dr
Ste D160
Voorhees, NJ 08043
Phone (856) 247-7800

218C Sunset Rd
Willingboro, NJ 08046
Phone (609) 877-0400

Organizations & group practices 3

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 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": "1350000000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1350000000000",
    "number": "1992057145",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "102 CENTRE BLVD STE E",
            "city": "MARLTON",
            "state": "NJ",
            "postal_code": "080534129",
            "telephone_number": "856-988-6260",
            "fax_number": "856-988-6270"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "102 CENTRE BLVD STE E",
            "city": "MARLTON",
            "state": "NJ",
            "postal_code": "080534129",
            "telephone_number": "856-988-6260",
            "fax_number": "856-988-6270"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CONVENTO",
        "first_name": "BROOKE",
        "middle_name": "M.",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-10-12",
        "last_updated": "2012-10-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "NJ",
            "license": "26NR14882000",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Marlton, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 12, 2012; 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.