Individual provider Active NPI

Mitchell Allen Cooperman, DPM

  • Podiatrist
  • Syosset, NY
National Provider Identifier
1487647608
Registry record updated Jun 25, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
N2841 Issued in NY
Practice address
346 S Oyster Bay Rd
Syosset, NY 11791-6912
Phone
(516) 931-3613
Fax
(516) 931-3320
NPI assigned
Aug 23, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 25, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X N2841 NY Primary

Addresses

Primary practice location

346 S Oyster Bay Rd
Syosset, NY 11791-6912

Mailing address

346 S Oyster Bay Rd
Syosset, NY 11791-6912
Phone (516) 931-3613

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
N2841NYMDPodiatrist

NPI Registry JSON

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

{
    "created_epoch": "1124755200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1214352000000",
    "number": "1487647608",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "346 S OYSTER BAY RD",
            "city": "SYOSSET",
            "state": "NY",
            "postal_code": "117916912",
            "telephone_number": "516-931-3613",
            "fax_number": "516-931-3320"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "346 S OYSTER BAY RD",
            "city": "SYOSSET",
            "state": "NY",
            "postal_code": "117916912",
            "telephone_number": "516-931-3613",
            "fax_number": "516-931-3320"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COOPERMAN",
        "first_name": "MITCHELL",
        "middle_name": "ALLEN",
        "name_prefix": "Dr.",
        "credential": "DPM",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-08-23",
        "last_updated": "2008-06-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "NY",
            "license": "N2841",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Syosset, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.