Daniel J Cooper, DO

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

20A6218 Issued in CA

Practice address

2505 W Hammer LN
Stockton, CA 95209-2839

Phone

(209) 957-7050

NPI assigned

Sep 13, 2005

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

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

Specialty

Family Practice

Education

College of Osteo Med of the Pacific at Pomona, 1991

Medicare assignment

May accept Medicare assignment

Group practices

Avalon Medical Development CorporationGroup PAC ID 1850283995, 28 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Catalina Island Medical Center Hospital, Avalon, CA, CCN 051307

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir-usa.unify.chbase.com/org/survalh-86281d9a
• Direct secure messaging: daniel.cooper.1@14021.direct.athenahealth.com

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.

• Avalon Medical Development Corporation

  • Critical Access Hospital
  • Avalon, CA
  • NPI 1346250347
  Medicare reassignment Care Compare group NPD
• Seneca Healthcare District

  • Medicare Defined Swing Bed Hospital Unit
  • Chester, CA
  • NPI 1326234022
  Medicare reassignment NPD
• Surprise Valley Health Care District

  • Critical Access Hospital
  • Cedarville, CA
  • NPI 1801973052
  Medicare reassignment NPD
• Seneca Healthcare District

  • Critical Access Hospital
  • Chester, CA
  • NPI 1396848677
  NPD
• Surprise Valley Health Care District

  • Medicare Defined Swing Bed Hospital Unit
  • Cedarville, CA
  • NPI 1023194222
  NPD
• Surprise Valley Health Care District

  • Rural Health Clinic/Center
  • Cedarville, CA
  • NPI 1073693651
  NPD (past)
• Sutter North Medical Foundation

  • Ambulatory Surgical Clinic/Center
  • Yuba City, CA
  • NPI 1144251521
  NPD (past)

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

• Avalon Medical Development Corporation

  • Critical Access Hospital
  • Avalon, CA
  • NPI 1346250347
  Care Compare affiliation

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

{
    "created_epoch": "1126569600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1790770022",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 COFFEE RD",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953554201",
            "telephone_number": "209-521-6097"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2505 W HAMMER LN",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "952092839",
            "telephone_number": "209-957-7050"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1561 Creekside Dr",
            "address_2": "Suite 150",
            "address_purpose": "LOCATION",
            "city": "Folsom",
            "state": "CA",
            "postal_code": "956303492",
            "country_code": "US",
            "telephone_number": "916-983-2193",
            "fax_number": "916-983-2285",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1561 Creekside Dr",
            "address_2": "Suite 150",
            "address_purpose": "LOCATION",
            "city": "Folsom",
            "state": "CA",
            "postal_code": "956303492",
            "country_code": "US",
            "telephone_number": "916-983-2193",
            "fax_number": "916-983-2285",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "COOPER",
        "first_name": "DANIEL",
        "middle_name": "J",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-09-13",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "20A6218",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00AX62180",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Bethany Cook
• Giovanna M Cook
• Tori Yvonne Cooke, PTA
• Mary E Coombs, LCSW
• Angelique Cooper
• Jazmine Michelle Cooper
• Tianna Cooper
• Jamie Sue Copeland
• Deron Derese Coplin
• Amy Marie Coppel

• Family Medicine Physician in Stockton, CA
• Providers in Stockton, CA by specialty
• Family Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.