COOPER UNIVERSITY TRAUMA PHYSICIANS, PC – Trauma Surgery Physician, NPI 1790724730

COOPER UNIVERSITY TRAUMA PHYSICIANS, PC is a healthcare provider. based in Camden, New Jersey. specializing in Trauma Surgery Physician. The NPI Number for COOPER UNIVERSITY TRAUMA PHYSICIANS, PC is 1790724730

Main info

Organization
Name
COOPER UNIVERSITY TRAUMA PHYSICIANS, PC
NPI
1790724730
Phone
(856) 356-4924
Address
1 FEDERAL STREET
Authorized Official
ANTHONY J. MAZZARELLI CHIEF MEDICAL OFFICE M.D.
Enumeration Date
5 June 2006
Last Update Date
27 July 2016
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience50
Completeness75
Years active:20State licenses:0Digital endpointsOther names

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Provider Addresses for COOPER UNIVERSITY TRAUMA PHYSICIANS, PC

  • 1, Federal Street, Cooper-Grant, Camden, Camden County, New Jersey, 08103, United States

    SW-200

    CAMDEN, NJ 081031155

    Phone: (856) 356-4924

    Fax: (856) 382-6455

    Type: Mailing

  • 1 Cooper Plaza, Haddon Avenue, Lanning Square, Camden, Camden County, New Jersey, 08103, United States

    CAMDEN, NJ 081031461

    Phone: (856) 342-3014

    Fax: (856) 342-2817

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2004-04-22

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Past revalidation due date

Earliest CMS due date was 2025-10-31 (222 days ago).

Enrollment records

1

Earliest due date

2025-10-31

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
O20040422000430OClinic/Group PracticeNJ2025-10-31

What to do next

  • Verify current status on the CMS Revalidation Lookup Tool immediately.
  • Complete revalidation in PECOS or contact your Medicare Administrative Contractor (MAC).
  • Overdue revalidation can lead to deactivation of Medicare billing privileges.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 08103)

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Reviews

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Frequently asked questions

What is the registry number for COOPER UNIVERSITY TRAUMA PHYSICIANS, PC?
The registry entry for COOPER UNIVERSITY TRAUMA PHYSICIANS, PC shows NPI 1790724730.
Quick check: is COOPER UNIVERSITY TRAUMA PHYSICIANS, PC active?
Public NPPES data shows COOPER UNIVERSITY TRAUMA PHYSICIANS, PC with an active NPI status right now.
What type of care does COOPER UNIVERSITY TRAUMA PHYSICIANS, PC provide?
COOPER UNIVERSITY TRAUMA PHYSICIANS, PC's profile centers on Trauma Surgery Physician. Clinical services aligned with this taxonomy classification.
Which community is linked to COOPER UNIVERSITY TRAUMA PHYSICIANS, PC?
COOPER UNIVERSITY TRAUMA PHYSICIANS, PC shows a connection to Camden, New Jersey in registry-derived data.
Why is information missing for COOPER UNIVERSITY TRAUMA PHYSICIANS, PC?
Providers choose how much contact data to publish. Missing fields do not mean the profile is fake.

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