Individual provider Active NPI

Aaron Kuperman, MD

  • Internal Medicine Physician
  • Pine Bluff, AR
National Provider Identifier
1376577619
Registry record updated Jul 23, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
E-4848 Issued in AR
Practice address
1600 W 40TH Ave
Attn: Hospitalist Department
Pine Bluff, AR 71603-6301
Phone
(870) 541-8767
Fax
(870) 541-7230
NPI assigned
Jul 11, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 23, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X E-4848 AR Primary

Addresses

Primary practice location

1600 W 40TH Ave
Attn: Hospitalist Department
Pine Bluff, AR 71603-6301

Mailing address

1600 W 40TH Ave
Attn: Hospitalist Department
Pine Bluff, AR 71603-6301
Phone (870) 541-8767

Other identifiers 1

IdentifierTypeStateIssuer
162208001MedicaidAR

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140428002008 TN Practitioner - Internal Medicine 1456357458 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
University of Arkansas College of Medicine, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Southeastern Physician Services PCGroup PAC ID 0042307852, 591 clinicians

Practice addresses (Care Compare)

1201 Bishop St
Union City, TN 38261-5403
Phone (731) 885-2410

6019 Walnut Grove Rd
Memphis, TN 38120-2113
Phone (901) 226-5000

Hospital & facility affiliations

  • Baptist Memorial Hospital Hospital, Memphis, TN, CCN 440048

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
E-4848ARMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Southeastern Physician Services PC Internal Medicine CurrentSince Apr 1, 2014 Accepting new patients
Baptist Memorial Hospital Past Accepting new patients

Locations

2305 Chambliss Ave NW
Cleveland, TN 37311
Phone (423) 559-6000

1201 Bishop St
Union City, TN 38261
Phone (423) 698-6061

Organizations & group practices 2

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": "1152576000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1279843200000",
    "number": "1376577619",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1600 W 40TH AVE",
            "address_2": "ATTN: HOSPITALIST DEPARTMENT",
            "city": "PINE BLUFF",
            "state": "AR",
            "postal_code": "716036301",
            "telephone_number": "870-541-8767",
            "fax_number": "870-541-7230"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1600 W 40TH AVE",
            "address_2": "ATTN: HOSPITALIST DEPARTMENT",
            "city": "PINE BLUFF",
            "state": "AR",
            "postal_code": "716036301",
            "telephone_number": "870-541-8767",
            "fax_number": "870-541-7230"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KUPERMAN",
        "first_name": "AARON",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-11",
        "last_updated": "2010-07-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "AR",
            "license": "E-4848",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "162208001",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pine Bluff, AR

Sources for this page

Verify at the official NPI Registry.