Active NPI
Donald P Copley, MD
- Cardiovascular Disease Physician
- Kenmore, NY
National Provider Identifier
1245296557
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Cardiovascular Disease Physician
- License
- 109170-1
- Practice address
- 3800 Delaware Ave
Suite 106
Kenmore, NY 14217-1094 - Phone
- (716) 874-1772
- Fax
- (716) 874-6925
- NPI assigned
- Apr 25, 2006
- 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 |
|---|---|---|---|---|
| Cardiovascular Disease Physician | 207RC0000X | 109170-1 | NY | Primary |
Addresses
Primary practice location
3800 Delaware Ave
Suite 106
Kenmore, NY 14217-1094
Mailing address
3800 Delaware Ave
Suite 106
Kenmore, NY 14217-1094
Phone (716) 874-1772
Other identifiers 9
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 000507329005 | Other | NY | HEALTH NOW |
| 00589973 | Medicaid | NY | |
| 109170-1B | Other | NY | WORKERS COMPENSATION |
| 00010035505 | Other | NY | UNIVERA |
| 0021748 | Other | NY | GHI |
| 2102744 | Other | NY | IHA |
| 060052392 | Other | NY | RR MEDICARE |
| 161000580 | Other | NY | NORTH AMERICAN PREFERRED |
| 161000580 | Other | NY | EMPIRE |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 109170 | NY | MD | Social Worker |
| 109170-1 | NY | MD | Cardiovascular Disease Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Mobile Diagnostic Testing Services Inc | Past | Accepting new patients | |
| Cardiology Reading Panel LLC | Cardiovascular Disease | 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.
-
- Cardiovascular Disease Physician
- Buffalo, NY
- NPI 1922041771
-
- Portable X-ray and/or Other Portable Diagnostic Imaging Supplier
- Buffalo, NY
- NPI 1902916448
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1145923200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1197849600000",
"number": "1245296557",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3800 DELAWARE AVE",
"address_2": "SUITE 106",
"city": "KENMORE",
"state": "NY",
"postal_code": "142171094",
"telephone_number": "716-874-1772",
"fax_number": "716-874-6925"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3800 DELAWARE AVE",
"address_2": "SUITE 106",
"city": "KENMORE",
"state": "NY",
"postal_code": "142171094",
"telephone_number": "716-874-1772",
"fax_number": "716-874-6925"
}
],
"practiceLocations": [],
"basic": {
"last_name": "COPLEY",
"first_name": "DONALD",
"middle_name": "P",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-04-25",
"last_updated": "2007-12-17",
"status": "A"
},
"taxonomies": [
{
"code": "207RC0000X",
"taxonomy_group": "",
"desc": "Internal Medicine, Cardiovascular Disease",
"state": "NY",
"license": "109170-1",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HEALTH NOW",
"identifier": "000507329005",
"state": "NY"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00589973",
"state": "NY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "WORKERS COMPENSATION",
"identifier": "109170-1B",
"state": "NY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UNIVERA",
"identifier": "00010035505",
"state": "NY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "GHI",
"identifier": "0021748",
"state": "NY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "IHA",
"identifier": "2102744",
"state": "NY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RR MEDICARE",
"identifier": "060052392",
"state": "NY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NORTH AMERICAN PREFERRED",
"identifier": "161000580",
"state": "NY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "EMPIRE",
"identifier": "161000580",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Kenmore, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 17, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.