Individual provider Active NPI

David G Kupkowski, MD

  • Family Medicine Physician
  • Buffalo, NY
National Provider Identifier
1467470211
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
215786-1 Issued in NY
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

Updated by the provider on Jul 9, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
02273081MedicaidNY

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20221116000006 FL Practitioner - Family PracticePractitioner - Hospitalist 7719969880 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family PracticeAlso: Hospitalist
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
Millennium Physician Group LLCGroup PAC ID 9830244433, 976 clinicians

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 Hospital, Sarasota, FL, CCN 100087

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
215786-1NYMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Millennium Physician Group LLC Family Medicine CurrentSince Dec 1, 2022 Accepting new patients
Millennium Physician Group LLC Family Medicine CurrentSince Dec 1, 2022 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

  • Direct secure messaging: 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.

Hospital & facility affiliations 1

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

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

Verify at the official NPI Registry.