Individual provider Active NPI

Martin M Cooper, MD

  • Geriatric Psychiatry Physician
  • Farmington, CT
National Provider Identifier
1174576334
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Geriatric Psychiatry PhysicianTaxonomy code 2084P0805X
License
023711 Issued in CT
Practice address
270 Farmington Ave
Suite 309
Farmington, CT 06032-1909
Phone
(860) 677-5570
Fax
(860) 677-9570
NPI assigned
May 18, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Geriatric Psychiatry Physician 2084P0805X 023711 CT Primary

Addresses

Primary practice location

270 Farmington Ave
Suite 309
Farmington, CT 06032-1909

Mailing address

270 Farmington Ave
Suite 309
Farmington, CT 06032-1909
Phone (860) 677-5570

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT
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 1

Enrollment IDStateProvider typePAC IDDetails
I20040401000127 CT Practitioner - Psychiatry 0547150773 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Other, 1976
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Connecticut Mental Health Specialists Inc 65 clinicians
Value Based Long Term Care K PC 61 clinicians

Practice addresses (Care Compare)

270 Farmington Ave
Farmington, CT 06032-1953
Phone (860) 677-5570

Hospital & facility affiliations

  • St Francis Hospital & Medical Center Hospital, Hartford, CT, CCN 070002
  • Middlesex Hospital Hospital, Middletown, CT, CCN 070020

Merit-based Incentive Payment System (MIPS)

Final score
54.94 of 100Reported as individual
Quality
48.65
Improvement activities
0
Cost
65.35

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
023711CTMDGeriatric Psychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Connecticut Mental Health Specialists Inc CurrentSince Mar 4, 1997 Accepting new patients

Locations

270 Farmington Ave
Ste 309
Farmington, CT 06032
Phone (860) 677-5570

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.

Hospital & facility affiliations 4

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": "1147910400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1174576334",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "270 FARMINGTON AVE",
            "address_2": "SUITE 309",
            "city": "FARMINGTON",
            "state": "CT",
            "postal_code": "060321909",
            "telephone_number": "860-677-5570",
            "fax_number": "860-677-9570"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "270 FARMINGTON AVE",
            "address_2": "SUITE 309",
            "city": "FARMINGTON",
            "state": "CT",
            "postal_code": "060321909",
            "telephone_number": "860-677-5570",
            "fax_number": "860-677-9570"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COOPER",
        "first_name": "MARTIN",
        "middle_name": "M",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-18",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0805X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Geriatric Psychiatry",
            "state": "CT",
            "license": "023711",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Farmington, CT

Sources for this page

Verify at the official NPI Registry.