Individual provider Active NPI

Richard J Kopf, PA-C

  • Medical Physician Assistant
  • Danbury, CT
National Provider Identifier
1396709556
Registry record updated Apr 9, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
000029 Issued in CT
Practice address
132 Main St
Danbury, CT 06810-7863
Phone
(203) 794-1979
Fax
(203) 794-1796
NPI assigned
Apr 14, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 9, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 000029 CT Primary

Addresses

Primary practice location

132 Main St
Danbury, CT 06810-7863

Mailing address

132 Main St
Danbury, CT 06810-7863
Phone (203) 794-1979

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
000029CTMDProfessional Counselor
29CTMDGenetic Counselor (M.S.)

Practice roles

OrganizationSpecialtyStatusNew patients
Danbury Medical Group LLC PastSince Jan 1, 1999 Accepting new patients
Prohealth Physicians PC PastSince Jan 9, 2023 Accepting new patients

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.

NPI Registry JSON

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

{
    "created_epoch": "1144972800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1365465600000",
    "number": "1396709556",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "132 MAIN ST",
            "city": "DANBURY",
            "state": "CT",
            "postal_code": "068107863",
            "telephone_number": "203-794-1979",
            "fax_number": "203-794-1796"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "132 MAIN ST",
            "city": "DANBURY",
            "state": "CT",
            "postal_code": "068107863",
            "telephone_number": "203-794-1979",
            "fax_number": "203-794-1796"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOPF",
        "first_name": "RICHARD",
        "middle_name": "J",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-14",
        "last_updated": "2013-04-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "CT",
            "license": "000029",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Danbury, CT

Sources for this page

Verify at the official NPI Registry.