Individual provider Active NPI

Susan Paulette Kupferman

  • Urology Physician
  • Bellevue, WA
National Provider Identifier
1659479830
Registry record updated Nov 19, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
License
MD00040018 Issued in WA
Practice address
1600 116TH Ave NE
Suite #104
Bellevue, WA 98004-3014
Phone
(425) 454-0345
NPI assigned
Sep 20, 2006
Last updated
Nov 19, 2013By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 19, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Urology Physician 208800000X MD00040018 WA Primary

Addresses

Primary practice location

1600 116TH Ave NE
Suite #104
Bellevue, WA 98004-3014

Mailing address

1600 116TH Ave NE
Suite #104
Bellevue, WA 98004-3014
Phone (425) 454-0345

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
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 1

Enrollment IDStateProvider typePAC IDDetails
I20040322001229 WA Practitioner - Obstetrics/GynecologyPractitioner - Urology 5890686653 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/GynecologyAlso: Urology
Education
Boston University School of Medicine, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

12910 Totem Lake Blvd NE
Suite 102
Kirkland, WA 98034-2901
Phone (425) 454-5758

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Susan Kupferman MD PLLC Urology CurrentSince Sep 2, 2003 Accepting new patients

Locations

1600 116th Ave NE
Ste 104
Bellevue, WA 98004
Phone (425) 454-0345

12910 Totem Lake Blvd NE
Ste 102
Kirkland, WA 98034
Phone (425) 899-4455

Interoperability endpoints

  • Direct secure messaging: susan.kupferman.1@24528.direct.athenahealth.com

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1158710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1384819200000",
    "number": "1659479830",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1600 116TH AVE NE",
            "address_2": "SUITE #104",
            "city": "BELLEVUE",
            "state": "WA",
            "postal_code": "980043014",
            "telephone_number": "425-454-0345"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1600 116TH AVE NE",
            "address_2": "SUITE #104",
            "city": "BELLEVUE",
            "state": "WA",
            "postal_code": "980043014",
            "telephone_number": "425-454-0345"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KUPFERMAN",
        "first_name": "SUSAN",
        "middle_name": "PAULETTE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-09-20",
        "last_updated": "2013-11-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "WA",
            "license": "MD00040018",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bellevue, WA

Sources for this page

Verify at the official NPI Registry.