Jacob Edwin Kuperstock, M.D.

Primary specialty

Otolaryngology/Facial Plastic Surgery PhysicianTaxonomy code 207YX0905X

License

0101266254 Issued in VA

Practice address

3801 University Dr Ste 300
Fairfax, VA 22030

Phone

(703) 383-8130

Fax

(703) 383-7355

NPI assigned

May 6, 2012

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in DC

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

Specialty

OtolaryngologyAlso: Plastic and Reconstructive Surgery

Education

Stanford University School of Medicine, 2013

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Otolaryngology Associates PCGroup PAC ID 8022188069, 31 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Inova Fairfax Hospital Hospital, Falls Church, VA, CCN 490063

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Otolaryngology Associates, PC

  • Otolaryngology Physician
  • Fairfax, VA
  • NPI 1861534836

  DC

  Medicare reassignment Care Compare group NPD
• Inova Health Care Services

  • Internal Medicine Physician
  • Falls Church, VA
  • NPI 1952320061

  DC

  Medicare reassignment
• Inova Health Care Services

  dba Inova Juniper Program

  • Multi-Specialty Clinic/Center
  • Fairfax, VA
  • NPI 1669511051
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Inova Health Care Services

  dba Inova Fairfax Hospital

  • Rehabilitation Hospital Unit
  • Falls Church, VA
  • NPI 1588795462
  Care Compare affiliation
• Inova Health Care Services

  dba Inova Fairfax Hospital

  • General Acute Care Hospital
  • Falls Church, VA
  • NPI 1831220714
  Care Compare affiliation

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

{
    "created_epoch": "1336262400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1563926400000",
    "number": "1700145182",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3801 UNIVERSITY DR STE 300",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220302503",
            "telephone_number": "703-383-8130",
            "fax_number": "703-383-7355"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3801 UNIVERSITY DR STE 300",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "22030",
            "telephone_number": "703-383-8130",
            "fax_number": "703-383-7355"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "830 Harrison Ave Ste 1400",
            "address_purpose": "LOCATION",
            "city": "Boston",
            "state": "MA",
            "postal_code": "021182905",
            "country_code": "US",
            "telephone_number": "617-638-8124",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KUPERSTOCK",
        "first_name": "JACOB",
        "middle_name": "EDWIN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-05-06",
        "last_updated": "2019-07-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "MA",
            "license": "255486",
            "primary": false
        },
        {
            "code": "207YX0905X",
            "taxonomy_group": "",
            "desc": "Otolaryngology, Otolaryngology/Facial Plastic Surgery",
            "state": "VA",
            "license": "0101266254",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kumaresansankaran,MD,PC
• Shelby Kunkel
• Resmi Kunnath
• Heather Kunz, ED.S., NCSP
• Alina Kuo, PHARM.D.
• Emily Kurinsky
• Minami Kurose, OD
• Robert N Kurtzke, M.D.
• Yuka Kuwahara
• Casey Kwak, NP

• Otolaryngology/Facial Plastic Surgery Physician in Fairfax, VA
• Providers in Fairfax, VA by specialty
• Otolaryngology/Facial Plastic Surgery Physician in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 2019; 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.