Active NPI
David G Kupkowski, MD
- Family Medicine Physician
- Buffalo, NY
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 215786-1
- Practice address
- 565 Abbott Rd
@ Mercy Hospital of Buffalo
Buffalo, NY 14220-2039 - Phone
- (518) 383-5450
- Fax
- (518) 383-4223
- NPI assigned
- Jul 18, 2006
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 215786-1 | NY | Primary |
Addresses
Primary practice location
565 Abbott Rd
@ Mercy Hospital of Buffalo
Buffalo, NY 14220-2039
Mailing address
565 Abbott Rd
@ Mercy Hospital of Buffalo
Buffalo, NY 14220-2039
Phone (518) 383-5450
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 02273081 | Medicaid | NY |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in FL
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Family Practice
- Education
- State University of New York at Buffalo School of Medicine, 1994
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
1700 S Tamiami TRL
Sarasota, FL 34239-3509
Phone (941) 917-9000
19531 Cochran Blvd
Port Charlotte, FL 33948-2081
Phone (941) 255-3535
2675 Winkler Ave
Fort Myers, FL 33901-9328
2675 Winkler Avenue
Suite 200
Fort Myers, FL 33901-9328
Hospital & facility affiliations
- Sarasota Memorial Hospital
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 215786-1 | NY | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Millennium Physician Group LLC | Family Medicine | Current | Accepting new patients |
| Millennium Physician Group LLC | Family Medicine | Current | Accepting new patients |
| Mercy Hospital of Buffalo | Past | Accepting new patients |
Locations
14540 Cortez Blvd
Ste 102
Brooksville, FL 34613
Phone (352) 596-7255
2675 Winkler Ave
Fl 2
Fort Myers, FL 33901
Phone (855) 979-5700
3434 Hancock Bridge Pkwy
Ste 301
North Ft Myers, FL 33903
Phone 877856377411108
2343 Aaron St
Pt Charlotte, FL 33952
Phone (855) 979-5700
19531 Cochran Blvd
Pt Charlotte, FL 33948
Phone (941) 255-3535
Interoperability endpoints
- david.kupkowski.1@4290.direct.athenahealth.com
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.
-
- Family Medicine Physician
- Fort Myers, FL
- NPI 1811122880
-
- Family Medicine Physician
- Brooksville, FL
- NPI 1073131702
-
- General Acute Care Hospital
- Buffalo, NY
- NPI 1164464921
Hospital & facility affiliations 1
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Sarasota, FL
- NPI 1245294826
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1153180800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183939200000",
"number": "1467470211",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "565 ABBOTT RD",
"address_2": "@ MERCY HOSPITAL OF BUFFALO",
"city": "BUFFALO",
"state": "NY",
"postal_code": "142202039",
"telephone_number": "518-383-5450",
"fax_number": "518-386-4223"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "565 ABBOTT RD",
"address_2": "@ MERCY HOSPITAL OF BUFFALO",
"city": "BUFFALO",
"state": "NY",
"postal_code": "142202039",
"telephone_number": "518-383-5450",
"fax_number": "518-383-4223"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KUPKOWSKI",
"first_name": "DAVID",
"middle_name": "G",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-07-18",
"last_updated": "2007-07-09",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "NY",
"license": "215786-1",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "02273081",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Buffalo, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; 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.