Individual provider Active NPI

Ronald B Kuppersmith, M.D.

  • Otolaryngology Physician
  • College Station, TX
National Provider Identifier
1013959287
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
License
L5799 Issued in TX
Practice address
1730 Birmingham Dr
College Station, TX 77845-4063
Phone
(979) 693-6000
Fax
(979) 693-1900
NPI assigned
Jun 12, 2006
Last updated
Mar 7, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Plastic Surgery within the Head & Neck (Otolaryngology) Physician 207YX0007X L5799 TX
Otolaryngic Allergy Physician 207YX0602X L5799 TX
Otolaryngology Physician 207Y00000X L5799 TX Primary

Addresses

Primary practice location

1730 Birmingham Dr
College Station, TX 77845-4063

Mailing address

PO Box 10194
College Station, TX 77842-0194
Phone (979) 693-6000

Other identifiers 1

IdentifierTypeStateIssuer
X0127267OtherTXDPS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20050810000678 TX Practitioner - Otolaryngology 0345279360 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Otolaryngology
Education
University of Michigan Medical School, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Texas ENT and Allergy Associates, LLPGroup PAC ID 0547299554, 13 clinicians

Practice addresses (Care Compare)

1730 Birmingham Rd
College Station, TX 77845-4063
Phone (979) 693-6000

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Texas ENT & Allergy Associates, LLP Otolaryngology CurrentSince Jul 1, 2005 Accepting new patients
Centers for Advanced ENT Care, LLC Otolaryngology PastSince Jul 26, 2023 Accepting new patients
Crescent Anesthesia Associates Past Accepting new patients

Locations

1730 Birmingham Rd
College Station, TX 77845
Phone (979) 693-6000

Networks

  • TX HMO

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/FIFJBD/Endpoint/FIFJBD

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

Hospital & facility affiliations 3

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": "1150070400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1013959287",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 10194",
            "city": "COLLEGE STATION",
            "state": "TX",
            "postal_code": "778420194",
            "telephone_number": "979-693-6000",
            "fax_number": "979-693-1900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1730 BIRMINGHAM DR",
            "city": "COLLEGE STATION",
            "state": "TX",
            "postal_code": "778454063",
            "telephone_number": "979-693-6000",
            "fax_number": "979-693-1900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KUPPERSMITH",
        "first_name": "RONALD",
        "middle_name": "B",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-12",
        "last_updated": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207YX0007X",
            "taxonomy_group": "",
            "desc": "Otolaryngology, Plastic Surgery within the Head & Neck",
            "state": "TX",
            "license": "L5799",
            "primary": false
        },
        {
            "code": "207YX0602X",
            "taxonomy_group": "",
            "desc": "Otolaryngology, Otolaryngic Allergy",
            "state": "TX",
            "license": "L5799",
            "primary": false
        },
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "TX",
            "license": "L5799",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DPS",
            "identifier": "X0127267",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in College Station, TX

Sources for this page

Verify at the official NPI Registry.