Jafar Koupaie, MD

Primary specialty

Procedural Dermatology PhysicianTaxonomy code 207NS0135X

License

C51581 Issued in CA

Practice address

9889 Magnolia Ave Ste a
Riverside, CA 92503-3581

Phone

(951) 566-5634

NPI assigned

Oct 25, 2006

Last updated

Jan 12, 2023By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in MA, CA2 enrollments

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 2

Specialty

Dermatology

Education

Other, 1970

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Advanced Dermatology and Skin Cancer SpecialistsGroup PAC ID 3678702206, 20 clinicians

BarayeGroup PAC ID 8123488996, 3 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Networks

• BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

• Direct secure messaging: advanceddermatologyandskin.jafarkoupaie@127196.advancedmd-direct.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Baraye

  dba Irvine Dermatology

  • Dermatology Physician
  • Irvine, CA
  • NPI 1760174882
  Medicare reassignment Care Compare group NPD
• Advanced Dermatology & Skin Cancer Specialists

  • Dermatology Physician
  • Temecula, CA
  • NPI 1881023927
  Medicare reassignment Care Compare group
• Canton Dermatology Clinic, Inc

  • Procedural Dermatology Physician
  • Canton, MA
  • NPI 1295819290
  Medicare reassignment Authorized official
• My Skin Institute, Inc

  dba Advanced Skin Institute

  • Dermatology Physician
  • Turlock, CA
  • NPI 1427352053
  Medicare reassignment NPD
• Hayes B. Gladstone, MD, PC.

  dba Gladstone Clinic for Skin Cancer, Lasers, Aesthetic Surgery

  • Dermatology Physician
  • Danville, CA
  • NPI 1376947978
  Medicare reassignment
• Edmund Yao MD Inc

  • Internal Medicine Physician
  • Stockton, CA
  • NPI 1285969139
  NPD
• Temecula Valley Family Physicians Inc.

  • Family Medicine Physician
  • Temecula, CA
  • NPI 1033323746
  NPD (past)

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

{
    "created_epoch": "1161734400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1673481600000",
    "number": "1508940644",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "95 WASHINGTON ST",
            "city": "CANTON",
            "state": "MA",
            "postal_code": "020214006",
            "telephone_number": "781-821-2888",
            "fax_number": "781-821-8684"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9889 MAGNOLIA AVE STE A",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925033581",
            "telephone_number": "951-566-5634"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "95 Washington St",
            "address_purpose": "LOCATION",
            "city": "Canton",
            "state": "MA",
            "postal_code": "020214006",
            "country_code": "US",
            "telephone_number": "781-821-2888",
            "fax_number": "781-821-8684",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KOUPAIE",
        "first_name": "JAFAR",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-25",
        "last_updated": "2023-01-12",
        "certification_date": "2023-01-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207NS0135X",
            "taxonomy_group": "",
            "desc": "Dermatology, Procedural Dermatology",
            "state": "MA",
            "license": "54177",
            "primary": false
        },
        {
            "code": "207NS0135X",
            "taxonomy_group": "",
            "desc": "Dermatology, Procedural Dermatology",
            "state": "CA",
            "license": "C51581",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nikhil Venkata Ragha Kotha, MD
• Naga Pattabhi Rama Sankar Kothapalli, MD
• Priyanka Kothia
• Richard Tsukasa Kotomori, M.D.
• Melissa Holly Kotzin, MS
• Elias George Koutros, D.D.S.
• Cory E Kowalski, PHD
• Jocelyn J Kraft
• Joseph Adam Kraft, DO
• Marlena Rapan Kraig, LMFT

• Procedural Dermatology Physician in Riverside, CA
• Providers in Riverside, CA by specialty
• Procedural Dermatology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 12, 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.

Verify at the official NPI Registry.