Individual provider Active NPI

Inna Kouperman, MPT

  • Specialist
  • Brooklyn, NY
National Provider Identifier
1205990975
Registry record updated Apr 20, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
025875-1 Issued in NY
Practice address
2200 Ocean Ave Apt 2D
Brooklyn, NY 11229-2236
Phone
(347) 251-2084
NPI assigned
Dec 20, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 20, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 025875-1 NY Primary

Addresses

Primary practice location

2200 Ocean Ave Apt 2D
Brooklyn, NY 11229-2236

Mailing address

2200 Ocean Ave Apt 2D
Brooklyn, NY 11229-2236
Phone (347) 251-2084

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050629001265 NY Practitioner - Physical Therapist in Private Practice 1153367164 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Excel PT Services PCGroup PAC ID 3375711732, 2 clinicians

Practice addresses (Care Compare)

2200 Ocean Ave
Apt 2D
Brooklyn, NY 11229-2236
Phone (347) 251-2084

Merit-based Incentive Payment System (MIPS)

Final score
21.11 of 100Reported as individual
Quality
0
Improvement activities
0
Cost
70.37

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
025875-1NYMDSpecialist

Practice roles

OrganizationSpecialtyStatusNew patients
Excel PT Services PC CurrentSince Mar 17, 2011 Accepting new patients
Spear Physical and Occupational Therapy, LLC 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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1166572800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1303257600000",
    "number": "1205990975",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2200 OCEAN AVE APT 2D",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112292236",
            "telephone_number": "347-251-2084"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2200 OCEAN AVE APT 2D",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112292236",
            "telephone_number": "347-251-2084"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOUPERMAN",
        "first_name": "INNA",
        "credential": "MPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-20",
        "last_updated": "2011-04-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NY",
            "license": "025875-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.