David Raymond Kopacz, M.D.

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

Practice address

302 W Hill St
Suite 203
Champaign, IL 61820-3562

Phone

(217) 363-2891

Fax

(217) 359-0322

NPI assigned

May 24, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IL, WI2 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

Psychiatry

Education

University of Illinois College of Med (CHI/Peor/Rock/CHM-Urb), 1993

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

MCCD FL Psychiatry Services PAGroup PAC ID 4880064070, 751 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• MCCD FL Psychiatry Services PA

  dba Talkiatry

  • Psychiatry Physician
  • Jacksonville, FL
  • NPI 1659003457

  IL, WI

  Medicare reassignment Care Compare group NPD
• David Kopacz, M.D.

  • Adult Mental Health Clinic/Center
  • Champaign, IL
  • NPI 1245403542
  NPD (past) Authorized official

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

{
    "created_epoch": "1148428800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1528013539",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "302 W HILL ST",
            "address_2": "SUITE 203",
            "city": "CHAMPAIGN",
            "state": "IL",
            "postal_code": "618203562",
            "telephone_number": "217-363-2891",
            "fax_number": "217-359-0322"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "302 W HILL ST",
            "address_2": "SUITE 203",
            "city": "CHAMPAIGN",
            "state": "IL",
            "postal_code": "618203562",
            "telephone_number": "217-363-2891",
            "fax_number": "217-359-0322"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOPACZ",
        "first_name": "DAVID",
        "middle_name": "RAYMOND",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-24",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kohta Komatsubara
• Ivo Komornicki
• Mary Elizabeth Konken, BA
• Heather Konzelmann, PA
• Tyler Koontz, LSW
• Rose Kormanyos, MA
• Maria Anissa Kouzoukas
• Sonja Marie Kovacev, RN
• Anuradha Nayar Kovilam
• Tiffany Kozlarek

• Psychiatry Physician in Champaign, IL
• Providers in Champaign, IL by specialty
• Psychiatry Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.