NPIMap

Individual provider Active NPI

Joshu E. Coppola, P.A.

  • Medical Physician Assistant
  • Liverpool, NY
National Provider Identifier
1942382528
Registry record updated Jun 2, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
011563 Issued in NY
Practice address
5100 W Taft Rd
Suite 1P
Liverpool, NY 13088-3807
Phone
(315) 452-2829
Fax
(315) 452-2870
NPI assigned
Oct 20, 2006
Last updated
Jun 2, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 2, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 011563 NY
Medical Physician Assistant 363AM0700X 011563 NY Primary

Addresses

Primary practice location

5100 W Taft Rd
Suite 1P
Liverpool, NY 13088-3807

Mailing address

611 Skyview Ter
Syracuse, NY 13219-2871
Phone (518) 201-4003

Other identifiers 1

IdentifierTypeStateIssuer
03316910MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070510000191 NY Practitioner - Physician Assistant 8022114826 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Plattsburgh Medical Care PLLCGroup PAC ID 8729088430, 9 clinicians

Practice addresses (Care Compare)

675 State Route 3
Plattsburgh, NY 12901-6562
Phone (518) 566-0672

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Wellnow Urgent Care, PC CurrentSince Apr 1, 2020 Accepting new patients
Plattsburgh Medical Care, PLLC CurrentSince Jan 5, 2026 Accepting new patients
Lake Ontario Prompt Medical Care, PLLC PastSince Apr 30, 2023 Accepting new patients
Lake Ontario Prompt Medical Care, PLLC PastSince May 29, 2014 Accepting new patients
Syracuse Community Health Center, Inc. Past Accepting new patients
Mountain Medical Services Past Accepting new patients

Locations

446 Fairview Ave
Ste 200
Hudson, NY 12534
Phone (518) 267-3496

7375 Oswego Rd
#1
Liverpool, NY 13090
Phone (315) 291-0064

200 E 1st St
Oswego, NY 13126
Phone (315) 207-7391

675 State Route 3
Plattsburgh, NY 12901
Phone (518) 566-0672

Interoperability endpoints

  • FHIR API: https://fhir.meditouchehr.com/api/fhir/r4/
  • Direct secure messaging: joshu.coppola.1@1798.direct.athenahealth.com

Organizations & group practices 8

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 3

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": "1161302400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1622592000000",
    "number": "1942382528",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "611 SKYVIEW TER",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132192871",
            "telephone_number": "518-201-4003",
            "fax_number": "315-452-2870"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5100 W TAFT RD",
            "address_2": "SUITE 1P",
            "city": "LIVERPOOL",
            "state": "NY",
            "postal_code": "130883807",
            "telephone_number": "315-452-2829",
            "fax_number": "315-452-2870"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COPPOLA",
        "first_name": "JOSHU",
        "middle_name": "E.",
        "credential": "P.A.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-20",
        "last_updated": "2021-06-02",
        "certification_date": "2021-06-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "011563",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NY",
            "license": "011563",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "03316910",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Liverpool, NY

Sources for this page

Verify at the official NPI Registry.