Active NPI
Kelsey Leigh Kuperman, PH.D., L.P.
- Psychologist
- Denver, CO
National Provider Identifier
1407215940
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- PSY.0006269
- Practice address
- 777 Bannock St
Denver, CO 80204-4507 - Phone
- (303) 602-2719
- NPI assigned
- Feb 11, 2016
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | PSY.0006269 | Primary |
Addresses
Primary practice location
777 Bannock St
Denver, CO 80204-4507
Mailing address
777 Bannock St
Denver, CO 80204-4507
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 500701105 | Medicaid | OR |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CO
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20240304000137 | CO | Practitioner - Clinical Psychologist | 0941645733 | Reassigns benefits to 1 organization |
Care Compare profile
Medicare Care Compare- Specialty
- Clinical Psychologist
- Education
- Other, 2022
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
777 Bannock St
Denver, CO 80204-4507
Phone (303) 436-6000
Hospital & facility affiliations
- Denver Health & Hospital Authority
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Philosophy
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Denver Health and Hospital Authority | Current | Accepting new patients | |
| Denver Health and Hospital Authority | Current | Accepting new patients | |
| Oslc Developments, Inc. - Clinic | Past | Accepting new patients |
Locations
777 Bannock St
Denver, CO 80204
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.
-
- Psychiatric Hospital Unit
- Denver, CO
- NPI 1689624942
-
- Mental Health Clinic/Center (Including Community Mental Health Center)
- Eugene, OR
- NPI 1326433012
Hospital & facility affiliations 3
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- Emergency Care Clinic/Center
- Winter Park, CO
- NPI 1467762435
Hospital
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1455148800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1708646400000",
"number": "1407215940",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "777 BANNOCK ST",
"city": "DENVER",
"state": "CO",
"postal_code": "802044507"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "777 BANNOCK ST",
"city": "DENVER",
"state": "CO",
"postal_code": "802044507",
"telephone_number": "303-602-2719"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KUPERMAN",
"first_name": "KELSEY",
"middle_name": "LEIGH",
"name_prefix": "Dr.",
"credential": "PH.D., L.P.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-02-11",
"last_updated": "2024-02-23",
"certification_date": "2024-02-23",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": null,
"license": "PSY.0006269",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "500701105",
"state": "OR"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Denver, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 23, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.