Individual provider Active NPI

Marina Kuperman, FNP

  • Primary Care Nurse Practitioner
  • Brooklyn, NY
National Provider Identifier
1043642887
Registry record updated Aug 6, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Nurse PractitionerTaxonomy code 363LP2300X
License
F337499 Issued in NY
Practice address
350 91St St Ste 1a
Brooklyn, NY 11209-5853
Phone
(718) 355-9705
Fax
(718) 355-8466
NPI assigned
Aug 3, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 6, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363LX0001X F3374991 NY
Primary Care Nurse Practitioner 363LP2300X F337499 NY Primary

Addresses

Primary practice location

350 91St St Ste 1a
Brooklyn, NY 11209-5853

Mailing address

4768 Hylan Blvd
Staten Island, NY 10312-6314
Phone (718) 753-3207

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200407002733 NY Practitioner - Nurse Practitioner 5496184376 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2012
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

350 91St St
Suite 1a
Brooklyn, NY 11209-5853
Phone (718) 355-9705

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
F337499NYMDPrimary Care Nurse Practitioner
F3374991NYMDObstetrics & Gynecology Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Marina Kuperman Family Health NP PC. Single Specialty CurrentSince Jan 1, 2020 Accepting new patients
Goncharov Medical, P.C. Single Specialty PastSince Sep 1, 2016 Accepting new patients

Locations

350 91st St
Ste 1A
Brooklyn, NY 11209
Phone (718) 355-9705

326 7th St
Brooklyn, NY 11215
Phone (718) 369-3300

144 McClean Ave
Fl 1
Staten Island, NY 10305
Phone (718) 355-9705

144 McClean Ave
#1
Staten Island, NY 10305

144 McClean Ave
Ste 1
Staten Island, NY 10305

Networks

  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H3359

Interoperability endpoints

  • Direct secure messaging: mkuperman61260@northwell.direct-ci.com
  • FHIR API: https://fhir.meditouchehr.com/api/fhir/r4/

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1375488000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722902400000",
    "number": "1043642887",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4768 HYLAN BLVD",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103126314",
            "telephone_number": "718-753-3207"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "350 91ST ST STE 1A",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112095853",
            "telephone_number": "718-355-9705",
            "fax_number": "718-355-8466"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KUPERMAN",
        "first_name": "MARINA",
        "name_prefix": "Mrs.",
        "credential": "FNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-08-03",
        "last_updated": "2024-08-06",
        "certification_date": "2024-08-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LX0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Obstetrics & Gynecology",
            "state": "NY",
            "license": "F3374991",
            "primary": false
        },
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "NY",
            "license": "F337499",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.