Individual provider Active NPI

Alyson L Coppola, RPA-C

  • Physician Assistant
  • Williamsville, NY
National Provider Identifier
1174817183
Registry record updated Sep 25, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
013863 Issued in NY
Practice address
8207 Main St
Suite 5
Williamsville, NY 14221-6060
Phone
(716) 632-2000
NPI assigned
Jun 7, 2011
Last updated
Sep 25, 2011By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 25, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 013863 NY Primary

Addresses

Primary practice location

8207 Main St
Suite 5
Williamsville, NY 14221-6060

Mailing address

125 Foxpoint W
Williamsville, NY 14221

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20111005000248 NY Practitioner - Physician Assistant 7810169307 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
013863NYMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Children's E.N.T., P.C. Past Accepting new patients

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, 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": "1307404800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1316908800000",
    "number": "1174817183",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "125 FOXPOINT W",
            "city": "WILLIAMSVILLE",
            "state": "NY",
            "postal_code": "14221"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8207 MAIN ST",
            "address_2": "SUITE 5",
            "city": "WILLIAMSVILLE",
            "state": "NY",
            "postal_code": "142216060",
            "telephone_number": "716-632-2000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COPPOLA",
        "first_name": "ALYSON",
        "middle_name": "L",
        "credential": "RPA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-06-07",
        "last_updated": "2011-09-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "013863",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Williamsville, NY

Sources for this page

Verify at the official NPI Registry.