Individual provider Active NPI

Stephanie Kops

  • Physician Assistant
  • East Longmeadow, MA
National Provider Identifier
1306449608
Registry record updated Nov 18, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
5029 Issued in CT
Practice address
1 Denslow Rd
East Longmeadow, MA 01028-3104
Phone
(203) 988-4342
NPI assigned
Nov 18, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 18, 2020

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 5029 CT Primary

Addresses

Primary practice location

1 Denslow Rd
East Longmeadow, MA 01028-3104

Mailing address

PO Box 120247
East Haven, CT 06512-0247
Phone (203) 988-4342

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT, FL2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20210421002654 CT Practitioner - Physician Assistant 0749698215 Reassigns benefits to 1 organization
I20220107001849 FL Practitioner - Physician Assistant 0749698215 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Simedhealth LLCGroup PAC ID 6608137054, 89 clinicians

Practice addresses (Care Compare)

4343 W Newberry Rd
Gainesville, FL 32607-2817
Phone (352) 416-1082

Merit-based Incentive Payment System (MIPS)

Final score
83 of 100Reported as group
Quality
65.57
Promoting interoperability
99
Improvement activities
40
Cost
78.6

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Simed Health LLC CurrentSince Nov 1, 2021 Accepting new patients

Locations

4881 NW 8th Ave
Ste 2
Gainesville, FL 32605
Phone (352) 373-6338

4343 Newberry Rd
Gainesville, FL 32607
Phone (352) 224-2200

Organizations & group practices 3

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": "1605657600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1605657600000",
    "number": "1306449608",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 120247",
            "city": "EAST HAVEN",
            "state": "CT",
            "postal_code": "065120247",
            "telephone_number": "203-988-4342"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 DENSLOW RD",
            "city": "EAST LONGMEADOW",
            "state": "MA",
            "postal_code": "010283104",
            "telephone_number": "203-988-4342"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOPS",
        "first_name": "STEPHANIE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-11-18",
        "last_updated": "2020-11-18",
        "certification_date": "2020-11-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CT",
            "license": "5029",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in East Longmeadow, MA

Sources for this page

Verify at the official NPI Registry.