Individual provider Active NPI

Nathaniel Robert Kopp, PA-C

  • Physician Assistant
  • Aurora, CO
National Provider Identifier
1861001638
Registry record updated Jul 28, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
1700 Wheeling St
Aurora, CO 80045-7211
Phone
(303) 399-8020
NPI assigned
Jul 28, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 28, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X Primary

Addresses

Primary practice location

1700 Wheeling St
Aurora, CO 80045-7211

Mailing address

38177 Adams Rd
Lisbon, OH 44432-9385
Phone (216) 258-4065

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20231011002557 OH Practitioner - Physician Assistant 4981023074 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cleveland ClinicGroup PAC ID 1850203555, 6,954 clinicians
Kettering Independent Medical Group IncGroup PAC ID 3173710936, 699 clinicians

Practice addresses (Care Compare)

33100 Cleveland Clinic Blvd
Avon, OH 44011-1390
Phone (440) 695-4000

3700 Southern Blvd
Suite 300
Kettering, OH 45429-1265
Phone (937) 558-3214

6780 Mayfield Rd
Mayfield Heights, OH 44124-2203

8950 Euclid Ave
Cleveland, OH 44195-0001
Phone (216) 444-8950

9500 Euclid Ave
Cleveland, OH 44195-0001

Hospital & facility affiliations

  • Hillcrest Hospital Hospital, Mayfield Heights, OH, CCN 360230
  • Cleveland Clinic Hospital, Cleveland, OH, CCN 360180

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
The Cleveland Clinic Foundation CurrentSince Sep 27, 2023 Accepting new patients
Lima Memorial Joint Operating Company Past Accepting new patients

Locations

9500 Euclid Ave
Cleveland, OH 44195
Phone (216) 442-1270

6801 Brecksville Rd
Ste 20
Seven Hills, OH 44131
Phone (216) 445-3363

Organizations & group practices 3

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 2

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": "1595894400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1595894400000",
    "number": "1861001638",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "38177 ADAMS RD",
            "city": "LISBON",
            "state": "OH",
            "postal_code": "444329385",
            "telephone_number": "216-258-4065"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1700 WHEELING ST",
            "city": "AURORA",
            "state": "CO",
            "postal_code": "800457211",
            "telephone_number": "303-399-8020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOPP",
        "first_name": "NATHANIEL",
        "middle_name": "ROBERT",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-07-28",
        "last_updated": "2020-07-28",
        "certification_date": "2020-07-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Aurora, CO

Sources for this page

Verify at the official NPI Registry.