Individual provider Active NPI

Matthew John Kopp, FNP-C

  • Family Nurse Practitioner
  • Bismarck, ND
National Provider Identifier
1245865377
Registry record updated Jun 29, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
R42025 Issued in ND
Practice address
300 N 7TH St
Bismarck, ND 58501-4439
Phone
(701) 323-6000
NPI assigned
Mar 9, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 29, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X R42025 ND Primary

Addresses

Primary practice location

300 N 7TH St
Bismarck, ND 58501-4439

Mailing address

PO Box 5074
Sioux Falls, SD 57117-5074
Phone (701) 202-5348

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ND
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
I20200324002799 ND Practitioner - Nurse Practitioner 8123456225 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sanford BismarckGroup PAC ID 9739098575, 562 clinicians

Practice addresses (Care Compare)

300 N 7TH St
Bismarck, ND 58501-4439
Phone (701) 323-6000

3318 N 14TH St
Bismarck, ND 58503-1614
Phone (701) 323-8300

Hospital & facility affiliations

  • Sanford Medical Center Bismarck Hospital, Bismarck, ND, CCN 350015

Merit-based Incentive Payment System (MIPS)

Final score
89.63 of 100Reported as group
Quality
89.39
Promoting interoperability
100
Improvement activities
40
Cost
76.04

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Sanford Bismarck CurrentSince Apr 13, 2020 Accepting new patients
Sanford Bismarck CurrentSince Apr 13, 2020 Accepting new patients

Locations

3318 N 14th St
Bismarck, ND 58503
Phone (701) 323-8300

300 N 7th St
Bismarck, ND 58501
Phone (701) 323-6153

Organizations & group practices 11

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 1

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": "1583712000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1656460800000",
    "number": "1245865377",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5074",
            "city": "SIOUX FALLS",
            "state": "SD",
            "postal_code": "571175074",
            "telephone_number": "701-202-5348"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 N 7TH ST",
            "city": "BISMARCK",
            "state": "ND",
            "postal_code": "585014439",
            "telephone_number": "701-323-6000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOPP",
        "first_name": "MATTHEW",
        "middle_name": "JOHN",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-03-09",
        "last_updated": "2022-06-29",
        "certification_date": "2022-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "ND",
            "license": "R42025",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bismarck, ND

Sources for this page

Verify at the official NPI Registry.