Individual provider Active NPI

David Cupp, MD

  • Retina Specialist (Ophthalmology) Physician
  • Sacramento, CA
National Provider Identifier
1497901565
Registry record updated Apr 3, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Retina Specialist (Ophthalmology) PhysicianTaxonomy code 207WX0107X
License
A120754 Issued in CA
Practice address
3939 J St
Suite 106
Sacramento, CA 95819-3636
Phone
(916) 454-4861
Fax
(916) 454-3603
NPI assigned
Aug 8, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 3, 2017

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X A120754 CA
Retina Specialist (Ophthalmology) Physician 207WX0107X A120754 CA Primary

Addresses

Primary practice location

3939 J St
Suite 106
Sacramento, CA 95819-3636

Mailing address

3939 J St
Suite 104
Sacramento, CA 95819-3636
Phone (916) 454-4861

Other identifiers 1

IdentifierTypeStateIssuer
0A1207540MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20120514000630 CA Practitioner - Ophthalmology 2365605144 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Ophthalmology
Education
Pennsylvania State University College of Medicine, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Vitreo-Retinal Medical Group, Inc.Group PAC ID 5799672275, 21 clinicians

Practice addresses (Care Compare)

1870 Lassen Blvd
Suite B
Yuba City, CA 95993-9455
Phone (530) 273-8358

Hospital & facility affiliations

  • Mercy General Hospital Hospital, Sacramento, CA, CCN 050017
  • Sierra Nevada Memorial Hospital Hospital, Grass Valley, CA, CCN 050150

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Quality
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A120754CAMDOphthalmology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
County of Los Angeles Current Accepting new patients
County of Los Angeles Auditor Controller CurrentSince Aug 1, 2014 Accepting new patients
County of Los Angeles CurrentSince Aug 1, 2014 Accepting new patients
Vitreo-Retinal Medical Group, Inc Retina Specialist CurrentSince Aug 1, 2014 Accepting new patients
Vitreo-Retinal Medical Group, Inc. Ophthalmology Current Accepting new patients
Vitreo-Retinal Medical Group, Inc. Ophthalmology CurrentSince Aug 1, 2014 Accepting new patients
Sutter Valley Hospitals Past Accepting new patients
Sutter North Medical Foundation Past Accepting new patients
Capitol Urology Medical Group Inc Past Accepting new patients
Dignity Health Past Accepting new patients
Port City Operating Company, LLC Past Accepting new patients

Locations

2460 Beacon St
Chico, CA 95928
Phone (530) 899-2251

9381 E Stockton Blvd
Ste 106
Elk Grove, CA 95624
Phone (916) 454-6191

2470 Hilborn Rd
Ste 150
Fairfield, CA 94534
Phone (707) 446-7676

2470 Hilborn Rd
Fairfield, CA 94534
Phone (707) 446-7676

2330 E Bidwell St
Ste 200
Folsom, CA 95630
Phone (916) 293-9381

300 Sierra College Dr
Ste 265
Grass Valley, CA 95945
Phone (530) 271-7070

4712 Stoddard Rd
Ste 180
Modesto, CA 95356
Phone (209) 549-8444

1680 E Roseville Pkwy
Ste 140
Roseville, CA 95661
Phone (916) 774-0100

3 Park Center Dr
Ste 100
Sacramento, CA 95825
Phone (916) 454-4861

5775 Greenback Ln
Sacramento, CA 95841
Phone (916) 339-3655

3939 J St
Ste 106
Sacramento, CA 95819
Phone (916) 454-4861

3 Park Center Dr
Ste 210
Sacramento, CA 95825
Phone (916) 454-6191

5771 Greenback Ln
Sacramento, CA 95841
Phone (916) 239-2042

3939 J St
Ste 104
Sacramento, CA 95819
Phone (916) 453-4768

3555 Deer Park Dr
Ste 180
Stockton, CA 95219
Phone (209) 461-3390

14445 Olive View Dr
Sylmar, CA 91342
Phone (881) 836-4303

615 International Pkwy
Ste 103
Tracy, CA 95377
Phone (209) 477-3007

1870 Lassen Blvd
Ste B
Yuba City, CA 95993
Phone (530) 273-8358

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • Direct secure messaging: david.cupp@direct.retinalmd.nextgenshare.com

Organizations & group practices 11

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 2

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": "1218153600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1491177600000",
    "number": "1497901565",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3939 J ST",
            "address_2": "SUITE 104",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958193636",
            "telephone_number": "916-454-4861",
            "fax_number": "916-454-3603"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3939 J ST",
            "address_2": "SUITE 106",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958193636",
            "telephone_number": "916-454-4861",
            "fax_number": "916-454-3603"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CUPP",
        "first_name": "DAVID",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-08-08",
        "last_updated": "2017-04-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "CA",
            "license": "A120754",
            "primary": false
        },
        {
            "code": "207WX0107X",
            "taxonomy_group": "",
            "desc": "Ophthalmology, Retina Specialist",
            "state": "CA",
            "license": "A120754",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0A1207540",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sacramento, CA

Sources for this page

Verify at the official NPI Registry.