Individual provider Active NPI

Taisiya Kupriyanova, RD, CDCES, CSOWM

  • Registered Dietitian
  • San Jose, CA
National Provider Identifier
1669731030
Registry record updated Sep 23, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
1049822 Issued in CA
Practice address
2577 Samaritan Dr
San Jose, CA 95124-4100
Phone
(408) 871-3400
NPI assigned
May 4, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 23, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X 1049822 CA Primary

Addresses

Primary practice location

2577 Samaritan Dr
San Jose, CA 95124-4100

Mailing address

2577 Samaritan Dr
San Jose, CA 95124-4100
Phone (408) 871-3400

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140108000954 CA Practitioner - Registered Dietitian Or Nutrition Professional 8325276843 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Registered Dietitian Or Nutrition Professional
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
El Camino Health Medical Network LLCGroup PAC ID 6103115183, 202 clinicians

Practice addresses (Care Compare)

815 Pollard Rd
Los Gatos, CA 95032-1438
Phone (408) 866-4070

Merit-based Incentive Payment System (MIPS)

Final score
85.48 of 100Reported as group
Quality
80.12
Promoting interoperability
100
Improvement activities
40
Cost
71.46

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1049822CAMDRegistered Dietitian

Practice roles

OrganizationSpecialtyStatusNew patients
DCHS Medical Foundation CurrentSince Nov 1, 2013 Accepting new patients
El Camino Health Medical Network, LLC CurrentSince Apr 1, 2019 Accepting new patients
Verity Medical Foundation CurrentSince Nov 1, 2013 Accepting new patients
El Camino Health Medical Group Past Accepting new patients
El Camino Hospital Past Accepting new patients

Locations

815 Pollard Rd
Los Gatos, CA 95032
Phone (408) 378-6131

25455 Medical Center Dr
Ste 200
Murrieta, CA 92562
Phone (951) 894-7056

9360 N Name Uno
San Francisco, CA 94139
Phone (408) 278-3003

2585 Samaritan Dr
San Jose, CA 95124
Phone (408) 278-3003

227 N Jackson Ave
San Jose, CA 95116
Phone (408) 278-3003

2577 Samaritan Dr
Ste 820
San Jose, CA 95124
Phone (408) 356-8150

2577 Samaritan Dr
Ste 860
San Jose, CA 95124
Phone (408) 358-2627

227 N Jackson Ave
Ste 100
San Jose, CA 95116
Phone (408) 866-4000

400 Race St
San Jose, CA 95126

2577 Samaritan Dr
Ste 840
San Jose, CA 95124
Phone (408) 356-2164

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1336089600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1632355200000",
    "number": "1669731030",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2577 SAMARITAN DR",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951244100",
            "telephone_number": "408-871-3400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2577 SAMARITAN DR",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951244100",
            "telephone_number": "408-871-3400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KUPRIYANOVA",
        "first_name": "TAISIYA",
        "credential": "RD, CDCES, CSOWM",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-05-04",
        "last_updated": "2021-09-23",
        "certification_date": "2021-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "CA",
            "license": "1049822",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Jose, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.