Individual provider Active NPI

Jacob Sloan Kopp, M.D.

  • Internal Medicine Physician
  • Grass Valley, CA
National Provider Identifier
1073054409
Registry record updated Jan 4, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
A167064 Issued in CA
Practice address
155 Glasson Way
Grass Valley, CA 95945-5723
Phone
(530) 274-6761
NPI assigned
Mar 18, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 4, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X A167064 CA Primary

Addresses

Primary practice location

155 Glasson Way
Grass Valley, CA 95945-5723

Mailing address

155 Glasson Way
Grass Valley, CA 95945-5723
Phone (530) 274-6761

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200811002193 CA Practitioner - HospitalistPractitioner - Internal Medicine 7416233101 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Hospitalist
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Dignity Health Medical FoundationGroup PAC ID 7810800661, 1,211 clinicians

Practice addresses (Care Compare)

155 Glasson Way
Suite L 10
Grass Valley, CA 95945-5723
Phone (530) 274-6677

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
99.64 of 100Reported as apm
Quality
86.27
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A167064CAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Dignity Health Medical Foundation CurrentSince Oct 9, 2021 Accepting new patients
Dignity Health Medical Foundation CurrentSince Oct 9, 2021 Accepting new patients
Dignity Health Medical Foundation Past Accepting new patients
Dignity Health Medical Foundation Past Accepting new patients

Locations

6555 Coyle Ave
Ste 280
Carmichael, CA 95608
Phone (916) 536-3540

280 Sierra College Dr
Ste 120
Grass Valley, CA 95945
Phone (530) 477-4420

155 Glasson Way
Grass Valley, CA 95945
Phone (530) 274-6000

155 Glasson Way
Ste L10
Grass Valley, CA 95945
Phone (530) 274-6677

3400 Data Dr
Rncho Cordova, CA 95670
Phone (916) 379-2726

3000 Q St
Fl 3
Sacramento, CA 95816
Phone (916) 733-3400

8120 Timberlake Way
Ste 107
Sacramento, CA 95823
Phone (916) 681-6000

3000 Q St
Sacramento, CA 95816
Phone (916) 733-5701

Organizations & group practices 4

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 1

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": "1489795200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1609718400000",
    "number": "1073054409",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "155 GLASSON WAY",
            "city": "GRASS VALLEY",
            "state": "CA",
            "postal_code": "959455723",
            "telephone_number": "530-274-6761"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "155 GLASSON WAY",
            "city": "GRASS VALLEY",
            "state": "CA",
            "postal_code": "959455723",
            "telephone_number": "530-274-6761"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOPP",
        "first_name": "JACOB",
        "middle_name": "SLOAN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-03-18",
        "last_updated": "2021-01-04",
        "certification_date": "2021-01-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A167064",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grass Valley, CA

Sources for this page

Verify at the official NPI Registry.