Active NPI
Grace N Kooper, M.D.
- Psychiatry Physician
- Brockton, MA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- 78340
- Practice address
- 680 Centre St
Brockton, MA 02302-3308 - Phone
- (808) 941-7228
- Fax
- (508) 941-6401
- NPI assigned
- Jan 5, 2006
- 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 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction Medicine (Preventive Medicine) Physician | 2083A0300X | 78340 | MA | |
| Psychiatry Physician | 2084P0800X | MD09334 | RI | |
| Psychiatry Physician | 2084P0800X | 78340 | MA | Primary |
Addresses
Primary practice location
680 Centre St
Brockton, MA 02302-3308
Mailing address
28 Willis Dr
Cumberland, RI 02864-2066
Phone (401) 258-1667
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 110055852A | Medicaid | MA | |
| 3139123 | Medicaid | MA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MA
- 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
- Psychiatry
- Education
- Warren Alpert Medical School of Brown University, 1991
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
101 Page St
New Bedford, MA 02740-3464
Phone (508) 973-5919
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- HHS exclusion list flag
- Flagged The directory lists this NPI on an HHS exclusion list.
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 78340 | MA | MD | Psychiatry Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Southcoast Physicians Group, Inc. | Current | Accepting new patients | |
| Saint Vincent Physician Services, Inc. | Psychiatry | Current | Accepting new patients |
| Southcoast Physicians Group, Inc. | Current | Accepting new patients | |
| Umass Memorial Medical Group Inc | Psychiatry | Past | Accepting new patients |
Locations
534 Prospect St
Fall River, MA 02720
Phone (508) 679-7766
101 Page St
New Bedford, MA 02740
Phone (508) 961-5425
55 Lake Ave N
Worcester, MA 01655
Phone 508334100048862
123 Summer St
Worcester, MA 01608
Phone (508) 363-6000
123 Summer St
#273
Worcester, MA 01608
Phone (508) 363-6327
Interoperability endpoints
- gkooper69814@direct.southcoast.org
Organizations & group practices 4
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
- Fairhaven, MA
- NPI 1336137629
-
- Family Medicine Physician
- Worcester, MA
- NPI 1013997329
Psychiatry
-
- Orthopaedic Surgery Physician
- North Dartmouth, MA
- NPI 1902201536
-
- Internal Medicine Physician
- Worcester, MA
- NPI 1760445373
Psychiatry
Hospital & facility affiliations 1
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Wareham, MA
- NPI 1922024835
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1136419200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1682380800000",
"number": "1477531895",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "28 WILLIS DR",
"city": "CUMBERLAND",
"state": "RI",
"postal_code": "028642066",
"telephone_number": "401-258-1667"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "680 CENTRE ST",
"city": "BROCKTON",
"state": "MA",
"postal_code": "023023308",
"telephone_number": "808-941-7228",
"fax_number": "508-941-6401"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KOOPER",
"first_name": "GRACE",
"middle_name": "N",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-01-05",
"last_updated": "2023-04-25",
"certification_date": "2023-04-25",
"status": "A"
},
"taxonomies": [
{
"code": "2083A0300X",
"taxonomy_group": "",
"desc": "Preventive Medicine, Addiction Medicine",
"state": "MA",
"license": "78340",
"primary": false
},
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "RI",
"license": "MD09334",
"primary": false
},
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "MA",
"license": "78340",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "110055852A",
"state": "MA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "3139123",
"state": "MA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Brockton, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 25, 2023; 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.