Max Christopher Kupferman, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA59562 Issued in CA

Practice address

4631 Teller Ave Ste 100
Newport Beach, CA 92660-8105

Phone

(949) 887-7187

Fax

(949) 476-3080

NPI assigned

May 26, 2021

Last updated

Dec 19, 2021By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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 CA

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

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

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.

• Harbor Psychiatry & Mental Health, Professional Corporation

  • Psychiatry Physician
  • Newport Beach, CA
  • NPI 1780050054
  Medicare reassignment

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

{
    "created_epoch": "1621987200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1639872000000",
    "number": "1629643028",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4631 TELLER AVE STE 100",
            "city": "NEWPORT BEACH",
            "state": "CA",
            "postal_code": "926608105",
            "telephone_number": "949-887-7187"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4631 TELLER AVE STE 100",
            "city": "NEWPORT BEACH",
            "state": "CA",
            "postal_code": "926608105",
            "telephone_number": "949-887-7187",
            "fax_number": "949-476-3080"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KUPFERMAN",
        "first_name": "MAX",
        "middle_name": "CHRISTOPHER",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-05-26",
        "last_updated": "2021-12-19",
        "certification_date": "2021-12-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA59562",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Allen Kuo, MD, MPH
• Clement Kuo
• Kevin Yuchun Kuo, PHARMD, RPH
• Tracy F Kuo, PHD, NP
• Ilan Kuperman, M.D.
• Katerina Kurteeva, MD
• Daria Joanna Kusior, PHARMD
• Isabelle Kuykendall
• Sandra Soohyun Kwak, M.D.
• Amy Kwan, MD

• Physician Assistant in Newport Beach, CA
• Providers in Newport Beach, CA by specialty
• Physician Assistant in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 19, 2021; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.