Individual provider Active NPI

Charles John Tupper Jr., M.D.

  • Psychiatry Physician
  • Helena, MT
National Provider Identifier
1700944121
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
7477 Issued in MT
Practice address
2755 Colonial Dr
Helena, MT 59601-4926
Phone
(406) 444-7500
NPI assigned
Dec 5, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 7477 MT Primary

Addresses

Primary practice location

2755 Colonial Dr
Helena, MT 59601-4926

Mailing address

PO Box 5539
Helena, MT 59604-5539
Phone (406) 444-7500

Other identifiers 1

IdentifierTypeStateIssuer
0045135MedicaidMT

Medicare participation

Medicare enrollment files
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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240614002945 CA Practitioner - Psychiatry 6507995495 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
University of Texas Medical School at San Antonio, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
County of San JoaquinGroup PAC ID 6002703436, 199 clinicians

Practice addresses (Care Compare)

1212 N California St
Stockton, CA 95202-1552
Phone (209) 468-8700

Merit-based Incentive Payment System (MIPS)

Final score
53.98 of 100Reported as group
Quality
11.8
Promoting interoperability
74
Improvement activities
0
Cost
82.7

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
7477MTMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
San Joaquin County Behavioral Health Services CurrentSince Jul 25, 2024 Accepting new patients
County of San Joaquin CurrentSince Jul 25, 2024 Accepting new patients
San Joaquin Behavioral Health Services Current Accepting new patients

Locations

1209 W Tokay St
Ste 5
Lodi, CA 95240
Phone (209) 331-2070

1212 N California St
Stockton, CA 95202
Phone (209) 468-8660

Organizations & group practices 3

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": "1165276800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1700944121",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5539",
            "city": "HELENA",
            "state": "MT",
            "postal_code": "596045539",
            "telephone_number": "406-444-7500",
            "fax_number": "406-444-7588"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2755 COLONIAL DR",
            "city": "HELENA",
            "state": "MT",
            "postal_code": "596014926",
            "telephone_number": "406-444-7500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TUPPER",
        "first_name": "CHARLES",
        "middle_name": "JOHN",
        "name_suffix": "Jr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-05",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "MT",
            "license": "7477",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0045135",
            "state": "MT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Helena, MT

Sources for this page

Verify at the official NPI Registry.