Organization Active NPI

Jeff D Kopelman, MD. F.a.C.S. PLLC

  • Otolaryngology Physician
  • Rockville Centre, NY
National Provider Identifier
1790084846
Registry record updated Mar 16, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
Legal business name
JEFF D KOPELMAN, MD. F.A.C.S. PLLC
Practice address
371 Merrick Rd
Suite 204
Rockville Centre, NY 11570-5359
Phone
(516) 536-4444
Fax
(516) 536-4486
NPI assigned
Mar 15, 2011
Last updated
Mar 16, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 16, 2011

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

Authorized official

Name
Jeff KopelmanNPI 1851363055
Title
Owner
Phone
(516) 536-4444

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology Physician 207Y00000X NU Primary

Addresses

Primary practice location

371 Merrick Rd
Suite 204
Rockville Centre, NY 11570-5359

Mailing address

371 Merrick Rd
Suite 204
Rockville Centre, NY 11570-5359
Phone (516) 536-4444

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20110408000259 NY Part B Supplier - Clinic/Group Practice 6800070277 Receives reassigned benefits from 1 practitioner
Practice locations: Rockville Centre, NY

National Provider Directory

National Provider Directory

Locations

371 Merrick Rd
Ste 204
Rockville Ctr, NY 11570
Phone (516) 536-4444

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1300147200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1300233600000",
    "number": "1790084846",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "371 MERRICK RD",
            "address_2": "SUITE 204",
            "city": "ROCKVILLE CENTRE",
            "state": "NY",
            "postal_code": "115705359",
            "telephone_number": "516-536-4444",
            "fax_number": "516-536-4486"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "371 MERRICK RD",
            "address_2": "SUITE 204",
            "city": "ROCKVILLE CENTRE",
            "state": "NY",
            "postal_code": "115705359",
            "telephone_number": "516-536-4444",
            "fax_number": "516-536-4486"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JEFF D KOPELMAN, MD. F.A.C.S. PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-03-15",
        "last_updated": "2011-03-16",
        "status": "A",
        "authorized_official_last_name": "KOPELMAN",
        "authorized_official_first_name": "JEFF",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "516-536-4444"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rockville Centre, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 16, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.