Bert Anthony Coppotelli, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

26684 Issued in CT

Practice address

2 Lee Rd
Lisbon, CT 06351-3015

Phone

(860) 376-4451

Fax

(860) 376-5977

NPI assigned

Jun 1, 2005

Last updated

Sep 5, 2007By 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 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

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.

• Bert Coppotelli MD LLC

  • Family Medicine Physician
  • Lisbon, CT
  • NPI 1699969469
  Authorized official Same address or phone
• Mark D. Deponte, M.D.,LLC

  • Family Medicine Physician
  • Lisbon, CT
  • NPI 1548591597
  NPD

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

{
    "created_epoch": "1117584000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1188950400000",
    "number": "1629070941",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 LEE RD",
            "city": "LISBON",
            "state": "CT",
            "postal_code": "063513015",
            "telephone_number": "860-376-4451",
            "fax_number": "860-376-5977"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 LEE RD",
            "city": "LISBON",
            "state": "CT",
            "postal_code": "063513015",
            "telephone_number": "860-376-4451",
            "fax_number": "860-376-5977"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COPPOTELLI",
        "first_name": "BERT",
        "middle_name": "ANTHONY",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-01",
        "last_updated": "2007-09-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CT",
            "license": "26684",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sherry R Catania, DMD
• Jason Edward Cavanaugh, OD
• Gurpreet Kaur Chandi, DDS
• Elda Cone
• Connecticut CVS Pharmacy LLC (CVS Pharmacy #17490)
• Molly Davis, PHARMD
• Denise Sandra Debrady, CADC, MSW
• Katryna Rae Deogburn, RD
• Mark David Deponte, MD
• Eastern Connecticut Rehabilitation Centers (Ecrc)

• Family Medicine Physician in Lisbon, CT
• Providers in Lisbon, CT by specialty
• Family Medicine Physician in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 5, 2007; 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.