Individual provider Active NPI

Jayson Koppinger, MD

  • Ophthalmology Physician
  • Truckee, CA
National Provider Identifier
1083076822
Registry record updated Dec 11, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
A154116 Issued in CA
Practice address
10121 Pine Ave
Truckee, CA 96161-4835
Phone
(530) 587-6011
NPI assigned
Mar 22, 2016
Last updated
Dec 11, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 11, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X A154116 CA Primary

Addresses

Primary practice location

10121 Pine Ave
Truckee, CA 96161-4835

Mailing address

10121 Pine Ave
Truckee, CA 96161-4835

Other practice location 1

275 W MacArthur Blvd
Oakland, CA 94611-5641
Phone (510) 752-1000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA, NV2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20230222000804 CA Practitioner - Ophthalmology 6608249610 Reassigns benefits to 2 organizations
I20230412002231 NV Practitioner - Ophthalmology 6608249610 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
75.06 of 100Reported as group
Quality
83.97
Promoting interoperability
88
Improvement activities
40
Cost
42.89

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A154116CAMDOphthalmology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Tahoe Forest Hospital District CurrentSince Feb 1, 2023 Accepting new patients
Tahoe Forest Hospital District Current Accepting new patients
Tahoe Forest Hospital District Current Accepting new patients
Tahoe Forest Hospital District CurrentSince Feb 1, 2023 Accepting new patients
Tahoe Forest Hospital District Current Accepting new patients

Locations

10051 Lake Ave
Ste 3
Truckee, CA 96161
Phone (530) 587-7461

10121 Pine Ave
Truckee, CA 96161
Phone (530) 582-3220

880 Alder Ave
Incline Vlg, NV 89451
Phone (775) 831-6200

889 Alder Ave
Ste 303
Incline Vlg, NV 89451
Phone (775) 831-7144

Interoperability endpoints

  • FHIR API: https://epic-fhir.mercy.net/PRDFHIRAOK2/TAO/api/FHIR/R4/

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1458604800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1670716800000",
    "number": "1083076822",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10121 PINE AVE",
            "city": "TRUCKEE",
            "state": "CA",
            "postal_code": "961614835"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10121 PINE AVE",
            "city": "TRUCKEE",
            "state": "CA",
            "postal_code": "961614835",
            "telephone_number": "530-587-6011"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "275 W MacArthur Blvd",
            "address_purpose": "LOCATION",
            "city": "Oakland",
            "state": "CA",
            "postal_code": "946115641",
            "country_code": "US",
            "telephone_number": "510-752-1000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KOPPINGER",
        "first_name": "JAYSON",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-03-22",
        "last_updated": "2022-12-11",
        "certification_date": "2022-12-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "CA",
            "license": "A154116",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Truckee, CA

Sources for this page

Verify at the official NPI Registry.