Individual provider Active NPI

Christine Maria Koropecky, MD

  • Specialist
  • East Patchogue, NY
National Provider Identifier
1871682336
Registry record updated Apr 29, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
166255 Issued in NY
Practice address
285 Sills Rd
Building 18
East Patchogue, NY 11772-4869
Phone
(631) 447-7140
NPI assigned
Oct 12, 2006
Last updated
Apr 29, 2010By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 29, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 166255 NY Primary

Addresses

Primary practice location

285 Sills Rd
Building 18
East Patchogue, NY 11772-4869

Mailing address

285 Sills Rd
Building 18
East Patchogue, NY 11772-4869
Phone (631) 447-7140

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
166255NYMDSpecialist

NPI Registry JSON

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

{
    "created_epoch": "1160611200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1272499200000",
    "number": "1871682336",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "285 SILLS RD",
            "address_2": "BUILDING 18",
            "city": "EAST PATCHOGUE",
            "state": "NY",
            "postal_code": "117724869",
            "telephone_number": "631-447-7140"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "285 SILLS RD",
            "address_2": "BUILDING 18",
            "city": "EAST PATCHOGUE",
            "state": "NY",
            "postal_code": "117724869",
            "telephone_number": "631-447-7140"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOROPECKY",
        "first_name": "CHRISTINE",
        "middle_name": "MARIA",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-10-12",
        "last_updated": "2010-04-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NY",
            "license": "166255",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in East Patchogue, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.