Active NPI
Mikhail J Kuprian, MD
- Internal Medicine Physician
- Colorado Springs, CO
National Provider Identifier
1104115708
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- 0051927
- Practice address
- 4105 Briargate Pkwy Ste 125
Colorado Springs, CO 80920 - Phone
- (303) 338-4545
- NPI assigned
- Apr 4, 2011
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 0051927 | CO | Primary |
Addresses
Primary practice location
4105 Briargate Pkwy Ste 125
Colorado Springs, CO 80920
Mailing address
10350 E Dakota Ave
Denver, CO 80247-1314
Phone (303) 338-4545
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 028871 | Other | CO | KAISER COMMERCIAL NUMBER |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CO
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20140804001600 | CO | Order and Referring Only - Internal Medicine | 3971720608 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1301875200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1531094400000",
"number": "1104115708",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10350 E DAKOTA AVE",
"city": "DENVER",
"state": "CO",
"postal_code": "802471314",
"telephone_number": "303-338-4545",
"fax_number": "303-344-7715"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4105 BRIARGATE PKWY STE 125",
"city": "COLORADO SPRINGS",
"state": "CO",
"postal_code": "80920",
"telephone_number": "303-338-4545"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KUPRIAN",
"first_name": "MIKHAIL",
"middle_name": "J",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2011-04-04",
"last_updated": "2018-07-09",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "CO",
"license": "0051927",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "KAISER COMMERCIAL NUMBER",
"identifier": "028871",
"state": "CO"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Colorado Springs, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.