Devin Coppola, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

201412-1 Issued in NY

Practice address

4615 North St
Jamesville, NY 13078-9499

Phone

(315) 469-7600

Fax

(315) 469-7775

NPI assigned

Jun 6, 2006

Last updated

Mar 7, 2023By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Jamesville Family Medicine and Wellness PC

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  • NPI 1245481225
  Authorized official Same address or phone
• Ar Physical Therapy PC

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• New York Em-I Medical Services PC

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  • Cortland, NY
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  NPD (past)

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

{
    "created_epoch": "1149552000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1306885108",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 340",
            "city": "NEW HARTFORD",
            "state": "NY",
            "postal_code": "134130340",
            "telephone_number": "315-732-9368",
            "fax_number": "315-732-9403"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4615 NORTH ST",
            "city": "JAMESVILLE",
            "state": "NY",
            "postal_code": "130789499",
            "telephone_number": "315-469-7600",
            "fax_number": "315-469-7775"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COPPOLA",
        "first_name": "DEVIN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-06",
        "last_updated": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NY",
            "license": "201412-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01964130",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Trameca Campbell, CD
• Claire Cariseo, CCC-SLP
• Sarah Theresa Carr, LMT
• Lindsey Marie Castle, REGISTERED NURSE
• Daniel Clark, DPT
• Dorothy Darcy
• Peter James Davis, PTA
• Genevieve M Defrancesco
• Kate Derrenbacker, MS, BCBA, LBA
• Vickie Lynn Desrosiers, LMT

• Family Medicine Physician in Jamesville, NY
• Providers in Jamesville, NY by specialty
• Family Medicine Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.