Organization Active NPI

Susan Kupferman MD PLLC

  • Urology Physician
  • Bellevue, WA
National Provider Identifier
1801087598
Registry record updated Nov 19, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
License
MD00040018 Issued in WA
Legal business name
SUSAN KUPFERMAN MD PLLC
Practice address
1600 116TH Ave NE
#104
Bellevue, WA 98004-3014
Phone
(425) 454-5758
NPI assigned
Aug 7, 2007
Last updated
Nov 19, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 19, 2013

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

Authorized official

Name
Nita L Harms
Title
Office Manager/Credentialer
Phone
(425) 454-0345

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Urology Physician 208800000X MD00040018 WA Primary

Addresses

Primary practice location

1600 116TH Ave NE
#104
Bellevue, WA 98004-3014

Mailing address

1600 116TH Ave NE
#104
Bellevue, WA 98004-3014
Phone (425) 454-5758

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040322001113 WA Part B Supplier - Clinic/Group Practice 7315838273 Receives reassigned benefits from 1 practitioner
Practice locations: Kirkland, WA

National Provider Directory

National Provider Directory

Locations

1600 116th Ave NE
Ste 104
Bellevue, WA 98004
Phone (425) 454-0345

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": "1186444800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1384819200000",
    "number": "1801087598",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1600 116TH AVE NE",
            "address_2": "#104",
            "city": "BELLEVUE",
            "state": "WA",
            "postal_code": "980043014",
            "telephone_number": "425-454-5758"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1600 116TH AVE NE",
            "address_2": "#104",
            "city": "BELLEVUE",
            "state": "WA",
            "postal_code": "980043014",
            "telephone_number": "425-454-5758"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUSAN KUPFERMAN MD PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-08-07",
        "last_updated": "2013-11-19",
        "status": "A",
        "authorized_official_last_name": "HARMS",
        "authorized_official_first_name": "NITA",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "OFFICE MANAGER/CREDENTIALER",
        "authorized_official_telephone_number": "425-454-0345"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "WA",
            "license": "MD00040018",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bellevue, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 2013; 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.