Individual provider Active NPI

Dustin Taylor Cooperman, M.D.

  • Anesthesiology Physician
  • Manhasset, NY
National Provider Identifier
1720344609
Registry record updated Dec 18, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
285238-1 Issued in NY
Practice address
300 Community Dr
Manhasset, NY 11030-3816
Phone
(516) 562-0100
NPI assigned
Apr 5, 2012
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 18, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 285238-1 NY Primary

Addresses

Primary practice location

300 Community Dr
Manhasset, NY 11030-3816

Mailing address

475 48TH Ave Apt 409
Long Island City, NY 11109-5505
Phone (516) 459-6672

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20161114001739 NY Practitioner - Anesthesiology 0648559781 Reassigns benefits to 6 organizations

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
New York Cardiovascular Anesthesiologists, P.C.Group PAC ID 5799676623, 135 clinicians

Practice addresses (Care Compare)

100 Port Washington Blvd
Roslyn, NY 11576-1347
Phone (516) 627-0334

Hospital & facility affiliations

  • St Francis Hospital - the Heart Center Hospital, Roslyn, NY, CCN 330182

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
285238-1NYMDAnesthesiology Physician
285238NYMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Montefiore Medical Center Anesthesiology CurrentSince Sep 11, 2016 Accepting new patients
Montefiore Medical Center CurrentSince Sep 11, 2016 Accepting new patients
New York Cardiovascular Anesthesiologists, P.C. Anesthesiology CurrentSince Nov 1, 2023 Accepting new patients
Sedation Vacation Perioperative Medicine PLLC CurrentSince Mar 17, 2022 Accepting new patients
Goldstep Ambulatory Surgery Center, LLC Anesthesiology CurrentSince Jan 15, 2020 Accepting new patients
North American Partners in Anesthesia LLP Anesthesiology CurrentSince Jun 1, 2017 Accepting new patients
Centurion Midtown Anesthesia PLLC Anesthesiology CurrentSince Jul 23, 2023 Accepting new patients

Locations

111 E 210th St
Bronx, NY 10467

200 Broadway
Ste 3149
Brooklyn, NY 11211

1396 Myrtle Ave
Brooklyn, NY 11237
Phone (718) 878-4313

3007 Farragut Rd
Brooklyn, NY 11210
Phone (347) 915-1177

10201 66th Rd
Forest Hills, NY 11375
Phone (718) 830-4091

4 Ohio Dr
New Hyde Park, NY 11042
Phone (516) 519-8260

1510 Jericho Tpke
New Hyde Park, NY 11040
Phone (516) 216-5341

10512 101st Ave
Ozone Park, NY 11416
Phone (718) 847-3600

300 Community Dr
Plandome, NY 11030

100 Port Washington Blvd
Roslyn, NY 11576
Phone (516) 562-6385

1000 Montauk Hwy
West Islip, NY 11795
Phone (516) 705-2689

Organizations & group practices 7

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.

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": "1333584000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1545091200000",
    "number": "1720344609",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "475 48TH AVE APT 409",
            "city": "LONG ISLAND CITY",
            "state": "NY",
            "postal_code": "111095505",
            "telephone_number": "516-459-6672"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 COMMUNITY DR",
            "city": "MANHASSET",
            "state": "NY",
            "postal_code": "110303816",
            "telephone_number": "516-562-0100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COOPERMAN",
        "first_name": "DUSTIN",
        "middle_name": "TAYLOR",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-04-05",
        "last_updated": "2018-12-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "NY",
            "license": "285238-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Manhasset, NY

Sources for this page

Verify at the official NPI Registry.