NPIMap

Individual provider Active NPI

Peter O Kuponiyi, MD

  • Addiction Medicine (Internal Medicine) Physician
  • Egg Harbor Township, NJ
National Provider Identifier
1285674010
Registry record updated May 13, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction Medicine (Internal Medicine) PhysicianTaxonomy code 207RA0401X
License
MA059488 Issued in NJ
Practice address
2626 Tilton Rd
Egg Harbor Township, NJ 08234-1829
Phone
(609) 568-5000
Fax
(609) 568-5010
NPI assigned
Jun 8, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 13, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction Medicine (Internal Medicine) Physician 207RA0401X MA059488 NJ Primary

Addresses

Primary practice location

2626 Tilton Rd
Egg Harbor Township, NJ 08234-1829

Mailing address

2626 Tilton Rd
Egg Harbor Township, NJ 08234-1829
Phone (609) 568-5000

Other identifiers 1

IdentifierTypeStateIssuer
5535603MedicaidNJ

Other names 1

  • Dr. Olatunji Kuponiyi Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060112000878 NJ Practitioner - Internal Medicine 0648259317 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1981
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Island Medical Associates PAGroup PAC ID 4284613951, 2 clinicians

Practice addresses (Care Compare)

2626 Tilton Rd
Egg Harbor Township, NJ 08234-1829
Phone (609) 568-5000

Hospital & facility affiliations

  • Bayada Home Health Care, Inc. Home health agency, Egg Harbor Township, NJ, CCN 317066
  • Patient Care Home health agency, Egg Harbor Township, NJ, CCN 317072
  • NJ Health Hospice and Palliative Care Hospice, Vineland, NJ, CCN 311568
  • Cape Regional Medical Center Inc Hospital, Cape May Court House, NJ, CCN 310011
  • Atlanticare Regional Medical Center - City Campus Hospital, Atlantic City, NJ, CCN 310064
  • Excel Care at the Pines Nursing home, Atlantic City, NJ, CCN 315317
  • Health Center at Galloway, the Nursing home, Galloway Township, NJ, CCN 315210
  • Meadowview Nursing and Rehabilitation Center Nursing home, Northfield, NJ, CCN 315358

Merit-based Incentive Payment System (MIPS)

Final score
98.62 of 100Reported as individual
Quality
90.18
Improvement activities
40
Cost
82.45

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MA059488NJMDAddiction Medicine (Internal Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Island Medical Associates,PA Addiction Medicine CurrentSince Dec 12, 2001 Accepting new patients
Atlanticare Regional Medical Center Past Accepting new patients
Galloway Nursing & Rehab LLC Past Accepting new patients
Shore Memorial Hospital Past Accepting new patients
Eastern Pines Care and Rehabilitation Center LLC Past Accepting new patients

Locations

29 N Vermont Ave
Atlantic City, NJ 08401
Phone (347) 362-1942

Interoperability endpoints

  • Direct secure messaging: peter.kuponiyi.1@21295.direct.athenahealth.com

Organizations & group practices 5

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 8

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": "1149724800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1305244800000",
    "number": "1285674010",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2626 TILTON RD",
            "city": "EGG HARBOR TOWNSHIP",
            "state": "NJ",
            "postal_code": "082341829",
            "telephone_number": "609-568-5000",
            "fax_number": "609-568-5010"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2626 TILTON RD",
            "city": "EGG HARBOR TOWNSHIP",
            "state": "NJ",
            "postal_code": "082341829",
            "telephone_number": "609-568-5000",
            "fax_number": "609-568-5010"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KUPONIYI",
        "first_name": "PETER",
        "middle_name": "O",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-08",
        "last_updated": "2011-05-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RA0401X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Addiction Medicine",
            "state": "NJ",
            "license": "MA059488",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5535603",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "OLATUNJI",
            "last_name": "KUPONIYI",
            "prefix": "DR.",
            "credential": "MD",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Egg Harbor Township, NJ

Sources for this page

Verify at the official NPI Registry.