Rafael Eugenio Coplin Reynoso, MD

Primary specialty

Critical Care Medicine (Internal Medicine) PhysicianTaxonomy code 207RC0200X

License

25875 Issued in WV

Practice address

900 E Broadway Ave
Bismarck, ND 58501-4520

Phone

(701) 530-4777

NPI assigned

Jun 2, 2006

Last updated

Mar 30, 2022By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 5

Addresses

Other identifiers 3

Other names 1

• Dr. Rafael Eugenio Coplin Reynoso Professional name

Medicare fee-for-service enrollment

Enrolled in GA, KY, WV, ND, IL, NY6 enrollments

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 6

Specialty

Internal Medicine

Education

Other, 1993

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Upstate Ny Doctor of Medicine PLLCGroup PAC ID 8628518750, 28 clinicians

St Alexius Medical CenterGroup PAC ID 8426960865, 239 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• CHI St Alexius Health Hospital, Bismarck, ND, CCN 350002
• St Marys Healthcare Hospital, Amsterdam, NY, CCN 330047
• CHI St Alexius Health Williston Hospital, Williston, ND, CCN 351334
• CHI St Alexius Health Dickinson Hospital, Dickinson, ND, CCN 351336

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: rcoplin509411@achce.catholichealth.net

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.

• St. Alexius Medical Center

  dba CHI St. Alexius Health Clinics

  • Specialist
  • Bismarck, ND
  • NPI 1205868429
  Medicare reassignment Care Compare group NPD
• Upstate Ny Doctor of Medicine PLLC

  • Hospitalist Physician
  • Amsterdam, NY
  • NPI 1356171490
  Medicare reassignment Care Compare group NPD
• Green Valley Hospital Medicine Physicians, LLC

  • Internal Medicine Physician
  • Paducah, KY
  • NPI 1215604236
  Medicare reassignment NPD
• Physician Services Corporation of Southern Illinois Inc.

  dba SSM Health Medical Group

  • Internal Medicine Physician
  • Mount Vernon, IL
  • NPI 1831101807
  Medicare reassignment NPD
• Southeastern Physician Services PC

  • Hospitalist Physician
  • Oak Ridge, TN
  • NPI 1083835441

  Internal Medicine, KY

  Medicare reassignment NPD
• St. Mary's Hospital, Centralia, Illinois

  dba SSM Health St. Mary's Hospital - Centralia

  • Emergency Medicine Physician
  • Centralia, IL
  • NPI 1770687196
  Medicare reassignment NPD
• Charleston Area Medical Center, Inc.

  • General Acute Care Hospital
  • Charleston, WV
  • NPI 1124248752
  Medicare reassignment
• Georgia Hospital Medicine Physicians LLC

  • Hospitalist Physician
  • Thomaston, GA
  • NPI 1164371415
  Medicare reassignment
• Good Samaritan Regional Health Center

  dba SSM Health Good Samaritan Hospital - Mt. Vernon

  • Emergency Medicine Physician
  • Mount Vernon, IL
  • NPI 1487758801
  Medicare reassignment
• St Alexius Medical Center

  dba CHI St. Alexius Health

  • Home Infusion Therapy Pharmacy
  • Bismarck, ND
  • NPI 1063663607
  NPD
• Decatur Memorial Hospital

  • General Acute Care Hospital
  • Decatur, IL
  • NPI 1164477725

  Internal Medicine

  NPD
• Decatur Memorial Hospital

  dba Professional Fees

  • Multi-Specialty Clinic/Center
  • Decatur, IL
  • NPI 1477276301
  NPD

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

• Mercy Medical Center

  dba Chi St Alexius Health Williston

  • Critical Access Hospital
  • Williston, ND
  • NPI 1902824576
  Care Compare affiliation
• St. Alexius Medical Center

  dba CHI St. Alexius Health

  • General Acute Care Hospital
  • Bismarck, ND
  • NPI 1306832654
  Care Compare affiliation
• St. Joseph's Hospital and Health Center

  dba CHI St Alexius Health Dickinson

  • Critical Access Hospital
  • Dickinson, ND
  • NPI 1992947956
  Care Compare affiliation
• St. Mary's Healthcare

  • General Acute Care Hospital
  • Amsterdam, NY
  • NPI 1811977796
  Care Compare affiliation

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

{
    "created_epoch": "1149206400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1648598400000",
    "number": "1427095702",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "900 E BROADWAY AVE",
            "city": "BISMARCK",
            "state": "ND",
            "postal_code": "585014520",
            "telephone_number": "701-530-4777"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "900 E BROADWAY AVE",
            "city": "BISMARCK",
            "state": "ND",
            "postal_code": "585014520",
            "telephone_number": "701-530-4777"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2300 N Edward St",
            "address_purpose": "LOCATION",
            "city": "Decatur",
            "state": "IL",
            "postal_code": "625264163",
            "country_code": "US",
            "telephone_number": "217-876-4200",
            "fax_number": "217-876-4209",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "COPLIN REYNOSO",
        "first_name": "RAFAEL",
        "middle_name": "EUGENIO",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-02",
        "last_updated": "2022-03-30",
        "certification_date": "2022-03-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "KY",
            "license": "45519",
            "primary": false
        },
        {
            "code": "207RC0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": "WV",
            "license": "25875",
            "primary": true
        },
        {
            "code": "207RC0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": "IL",
            "license": "036155263",
            "primary": false
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "IL",
            "license": "036155263",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "KY",
            "license": "45519",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "110239640",
            "state": "AL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100213570",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "051529239",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "RAFAEL",
            "last_name": "COPLIN REYNOSO",
            "middle_name": "EUGENIO",
            "prefix": "DR.",
            "credential": "MD",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Kaidra Connor
• Continuity of Direct Primary Care & Services PLLC
• Jordyn Cook
• Ranon Cook, MD
• Taylor Lynn Cook
• David Coppock
• Kayla Corbin, PHARMD
• Core Family Chiropractic, PLC
• William Eugene Cornatzer Jr., M.D.
• Carissa R Cornell, NP

• Critical Care Medicine (Internal Medicine) Physician in Bismarck, ND
• Providers in Bismarck, ND by specialty
• Critical Care Medicine (Internal Medicine) Physician in North Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 30, 2022; 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.

Verify at the official NPI Registry.