Individual provider Active NPI

Thomas Copperman, MD

  • Ophthalmology Physician
  • Seattle, WA
National Provider Identifier
1710220330
Registry record updated Jun 3, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
MD61042379 Issued in WA
Practice address
1101 Madison St Ste 600
Seattle, WA 98104-1340
Phone
(206) 215-2020
Fax
(206) 215-2022
NPI assigned
Apr 2, 2013
Last updated
Jun 3, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 3, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X MD61042379 WA Primary
Ophthalmic Plastic and Reconstructive Surgery Physician 207WX0200X MD61043249 WA

Addresses

Primary practice location

1101 Madison St Ste 600
Seattle, WA 98104-1340

Mailing address

1101 Madison St Ste 600
Seattle, WA 98104-1340
Phone (206) 215-2020

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA, WA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20170601001116 CA Practitioner - Ophthalmology 9739323585 Reassigns benefits to 1 organization
I20200323003295 WA Practitioner - Ophthalmology 9739323585 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Ophthalmology
Education
Wright State University Boonshoft School of Medicine, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Eye Associates Northwest PLLCGroup PAC ID 2961397385, 10 clinicians
Evergreen Eye Center PLLCGroup PAC ID 3173410057, 33 clinicians

Practice addresses (Care Compare)

1101 Madison St
Suite 600
Seattle, WA 98104-3501
Phone (206) 215-2020

11325 NE 120TH St
Kirkland, WA 98034-6907
Phone (425) 821-6655

1455 NW Leary Way
Suite 300
Seattle, WA 98107-5138
Phone (206) 784-3350

34719 6TH Ave S
Federal Way, WA 98003-8714
Phone (206) 212-2100

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
84.62 of 100Reported as group
Quality
85.07
Improvement activities
40
Cost
76.1

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision15

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD61042379WAMDOphthalmology Physician
MD61043249WAMDOphthalmology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University of California SFGH Medical Group CurrentSince May 15, 2017 Accepting new patients
Evergreen Eye Center, PLLC CurrentSince May 4, 2020 Accepting new patients
University of California SFGH Medical Group Current Accepting new patients
Evergreen Eye Center, PLLC Ophthalmology CurrentSince Apr 8, 2024 Accepting new patients
University of California SFGH Medical Group Ophthalmology CurrentSince May 15, 2017 Accepting new patients
Eye Associates Northwest, PLLC Ophthalmology CurrentSince May 4, 2020 Accepting new patients
Evergreen Eye Center, PLLC Ophthalmology Past Accepting new patients
Evergreen Eye Center, PLLC Ophthalmology Past Accepting new patients
Evergreen Eye Center, PLLC Past Accepting new patients

Locations

1001 Potrero Ave
Rm 3A
San Francisco, CA 94110
Phone (415) 206-4632

34719 6th Ave S
Federal Way, WA 98003
Phone (206) 212-2100

1101 Madison St
Ste 600
Seattle, WA 98104
Phone (206) 215-2004

1455 NW Leary Way
Ste 300
Seattle, WA 98107
Phone (206) 784-3350

Organizations & group practices 9

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.

Hospital & facility affiliations 1

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

NPI Registry JSON

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

{
    "created_epoch": "1364860800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1591142400000",
    "number": "1710220330",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1101 MADISON ST STE 600",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981041340",
            "telephone_number": "206-215-2020",
            "fax_number": "206-215-2022"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1101 MADISON ST STE 600",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981041340",
            "telephone_number": "206-215-2020",
            "fax_number": "206-215-2022"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COPPERMAN",
        "first_name": "THOMAS",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-04-02",
        "last_updated": "2020-06-03",
        "certification_date": "2020-06-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "WA",
            "license": "MD61042379",
            "primary": true
        },
        {
            "code": "207WX0200X",
            "taxonomy_group": "",
            "desc": "Ophthalmology, Ophthalmic Plastic and Reconstructive Surgery",
            "state": "WA",
            "license": "MD61043249",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Seattle, WA

Sources for this page

Verify at the official NPI Registry.