Individual provider Active NPI

Mike Kuoppamaki, DC

  • Chiropractor
  • San Diego, CA
National Provider Identifier
1700177540
Registry record updated Apr 27, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
DC 31108 Issued in CA
Practice address
3784 Clairemont Dr
San Diego, CA 92117-5916
Phone
(858) 272-0074
Fax
(858) 272-7574
NPI assigned
Apr 27, 2011
Last updated
Apr 27, 2011By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 27, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X DC 31108 CA Primary

Addresses

Primary practice location

3784 Clairemont Dr
San Diego, CA 92117-5916

Mailing address

3784 Clairemont Dr
San Diego, CA 92117-5916

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110719000600 CA Practitioner - Chiropractic 8022286079 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Los Angeles College of Chiropractic, 2008
Medicare assignment
May accept Medicare assignment
Group practices
Core Health-Spine and Sports Care ApcGroup PAC ID 9032571054, 2 clinicians

Practice addresses (Care Compare)

3784 Clairemont Dr
San Diego, CA 92117-5916
Phone (858) 272-0074

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DC 31108CAMDChiropractor
31108CAMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Core Health - Spine and Sports Care Apc Chiropractor CurrentSince Sep 23, 2023 Accepting new patients

Locations

3784 Clairemont Dr
San Diego, CA 92117
Phone (858) 272-0074

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": "1303862400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1303862400000",
    "number": "1700177540",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3784 CLAIREMONT DR",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921175916"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3784 CLAIREMONT DR",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921175916",
            "telephone_number": "858-272-0074",
            "fax_number": "858-272-7574"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KUOPPAMAKI",
        "first_name": "MIKE",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-04-27",
        "last_updated": "2011-04-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "CA",
            "license": "DC 31108",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 27, 2011; 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.