NPIMap

Individual provider Active NPI

Peter Nicholas Copsis, MD

  • Internal Medicine Physician
  • Matthews, NC
National Provider Identifier
1417979485
Registry record updated Nov 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
39724 Issued in NC
Practice address
630 Matthews Township Pkwy
Matthews, NC 28105-5322
Phone
(704) 495-6020
NPI assigned
Jul 25, 2006
Last updated
Nov 11, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 11, 2024

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 39724 NC Primary

Addresses

Primary practice location

630 Matthews Township Pkwy
Matthews, NC 28105-5322

Mailing address

5960 Fairview Rd Ste 500
Charlotte, NC 28210-3113
Phone (704) 495-6334

Other practice location 1

332 N. Trade Street
Suite 2000
Matthews, NC 28105-6566
Phone (704) 302-8500

Other identifiers 3

IdentifierTypeStateIssuer
1417979485MedicaidNC
N39724MedicaidSC
8924271MedicaidNC

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20051212000494 NC Practitioner - Internal Medicine 0042231698 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
University of North Carolina at Chapel Hill School of Medicine, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Tryon Medical Partners, PLLCGroup PAC ID 7113277971, 139 clinicians

Practice addresses (Care Compare)

11030 Golf Links Dr
Suite 100
Charlotte, NC 28277-8047
Phone (704) 495-6334

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Tryon Medical Partners, PLLC Internal Medicine CurrentSince Sep 1, 2018 Accepting new patients

Locations

11030 Golf Links Dr
Ste 100
Charlotte, NC 28277
Phone (704) 384-1166

5950 Fairview Rd
Ste 330
Charlotte, NC 28210

5960 Fairview Rd
Ste 500
Charlotte, NC 28210

630 Matthews Township Pkwy
Matthews, NC 28105
Phone (704) 495-6020

Interoperability endpoints

  • Direct secure messaging: peter.copsis.1@17278.direct.athenahealth.com
  • Direct secure messaging: peter.copsis.1@17847.direct.athenahealth.com

Organizations & group practices 1

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.

Hospital & facility affiliations 18

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 18

NPI Registry JSON

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

{
    "created_epoch": "1153785600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731283200000",
    "number": "1417979485",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5960 FAIRVIEW RD STE 500",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282103113",
            "telephone_number": "704-495-6334",
            "fax_number": "704-817-7219"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "630 MATTHEWS TOWNSHIP PKWY",
            "city": "MATTHEWS",
            "state": "NC",
            "postal_code": "281055322",
            "telephone_number": "704-495-6020"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "332 N. Trade Street",
            "address_2": "Suite 2000",
            "address_purpose": "LOCATION",
            "city": "Matthews",
            "state": "NC",
            "postal_code": "281056566",
            "country_code": "US",
            "telephone_number": "704-302-8500",
            "fax_number": "704-302-8501",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "COPSIS",
        "first_name": "PETER",
        "middle_name": "NICHOLAS",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-25",
        "last_updated": "2024-11-11",
        "certification_date": "2024-11-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NC",
            "license": "39724",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1417979485",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "N39724",
            "state": "SC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8924271",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Matthews, NC

Sources for this page

Verify at the official NPI Registry.