Miranda L Kopnisky, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA4046 Issued in MA

Practice address

585 Lebanon St
Melrose, MA 02176-3225

Phone

(781) 979-3635

NPI assigned

Sep 29, 2010

Sex

Female

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 MA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 2010

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Hallmark Health Urgent Care Physicians LLCGroup PAC ID 1153557616, 33 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Interoperability endpoints

• Direct secure messaging: mkopnisky28726@tuftsmedicine.direct-ci.com

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.

• Hallmark Health Urgent Care Physicians LLC

  • Emergency Medicine Physician
  • Reading, MA
  • NPI 1184066912
  Medicare reassignment Care Compare group
• Melrose Wakefield Emergency Physicians, Inc.

  • Emergency Medicine Physician
  • Melrose, MA
  • NPI 1790730539
  Medicare reassignment

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

{
    "created_epoch": "1285718400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1351036800000",
    "number": "1578872255",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "585 LEBANON ST",
            "city": "MELROSE",
            "state": "MA",
            "postal_code": "021763225"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "585 LEBANON ST",
            "city": "MELROSE",
            "state": "MA",
            "postal_code": "021763225",
            "telephone_number": "781-979-3635"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOPNISKY",
        "first_name": "MIRANDA",
        "middle_name": "L",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-09-29",
        "last_updated": "2012-10-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MA",
            "license": "PA4046",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Gary Kleeman, DO
• Rachael Knight
• Jacob Knudsen
• Alexandra Koerten, RN, IBCLC
• Laura Konaxis, LICSW
• Geraldine S. Koppenaal, RNCS
• Steven Ira Kornbleuth, MD
• Sybil Meg Kramer, MD
• Martha S Krikeles, MD
• Vicki Shangraw Kvedar, MD

• Physician Assistant in Melrose, MA
• Providers in Melrose, MA by specialty
• Physician Assistant in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 2012; 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.