Individual provider Active NPI

Christopher Brian Cooper, PA-C

  • Physician Assistant
  • Springfield, MA
National Provider Identifier
1366925919
Registry record updated Sep 10, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA6711 Issued in MA
Practice address
305 Bicentennial Hwy
Springfield, MA 01118-1962
Phone
(413) 523-0999
NPI assigned
Sep 10, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 10, 2018

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 PA6711 MA Primary

Addresses

Primary practice location

305 Bicentennial Hwy
Springfield, MA 01118-1962

Mailing address

305 Bicentennial Hwy
Springfield, MA 01118-1967

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
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
I20181106002695 MA Practitioner - Physician Assistant 9234483447 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Riverbend Medical Group IncGroup PAC ID 5698064343, 227 clinicians

Practice addresses (Care Compare)

233 Carew St
Springfield, MA 01104-2377
Phone (413) 748-9212

271 Carew St
Springfield, MA 01104-2377
Phone (413) 748-9000

Hospital & facility affiliations

  • Mercy Medical Ctr Hospital, Springfield, MA, CCN 220066

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Riverbend Medical Group, Inc CurrentSince Sep 15, 2018 Accepting new patients
Mwa,PC Past Accepting new patients

Locations

299 Carew St
Ste 410
Springfield, MA 01104
Phone (413) 734-1883

305 Bicentennial Hwy
Springfield, MA 01118
Phone (413) 733-4101

233 Carew St
#101
Springfield, MA 01104
Phone (413) 748-9212

271 Carew St
Springfield, MA 01104
Phone (413) 748-9000

Interoperability endpoints

  • Direct secure messaging: ccooper2386785@direct.trinity-health.org

Organizations & group practices 4

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 2

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": "1536537600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1536537600000",
    "number": "1366925919",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "305 BICENTENNIAL HWY",
            "city": "SPRINGFIELD",
            "state": "MA",
            "postal_code": "011181967"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "305 BICENTENNIAL HWY",
            "city": "SPRINGFIELD",
            "state": "MA",
            "postal_code": "011181962",
            "telephone_number": "413-523-0999"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COOPER",
        "first_name": "CHRISTOPHER",
        "middle_name": "BRIAN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-09-10",
        "last_updated": "2018-09-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MA",
            "license": "PA6711",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Springfield, MA

Sources for this page

Verify at the official NPI Registry.