Individual provider Active NPI

Jeffrey Leon Kupperman, M.D.

  • Pulmonary Disease Physician
  • Santa Barbara, CA
National Provider Identifier
1104810738
Registry record updated Aug 14, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pulmonary Disease PhysicianTaxonomy code 207RP1001X
License
G34672 Issued in CA
Practice address
2428 Castillo St
Suite D
Santa Barbara, CA 93105
Phone
(805) 845-1500
Fax
(805) 845-0333
NPI assigned
Sep 9, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 14, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pulmonary Disease Physician 207RP1001X G34672 CA Primary

Addresses

Primary practice location

2428 Castillo St
Suite D
Santa Barbara, CA 93105

Mailing address

PO Box 50706
Santa Barbara, CA 93150-0706
Phone (805) 963-3757

Other identifiers 2

IdentifierTypeStateIssuer
290011938OtherCARAILROAD MEDICARE
00G346720MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
G34672CAMDPulmonary Disease Physician

NPI Registry JSON

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

{
    "created_epoch": "1126224000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1534204800000",
    "number": "1104810738",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 50706",
            "city": "SANTA BARBARA",
            "state": "CA",
            "postal_code": "931500706",
            "telephone_number": "805-963-3757",
            "fax_number": "805-564-3332"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2428 CASTILLO ST",
            "address_2": "SUITE D",
            "city": "SANTA BARBARA",
            "state": "CA",
            "postal_code": "93105",
            "telephone_number": "805-845-1500",
            "fax_number": "805-845-0333"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KUPPERMAN",
        "first_name": "JEFFREY",
        "middle_name": "LEON",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-09-09",
        "last_updated": "2018-08-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "CA",
            "license": "G34672",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "290011938",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G346720",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Barbara, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.