NPIMap

Individual provider Active NPI

Shelby S Cooper, M.D.

  • Vascular Surgery Physician
  • Cooperstown, NY
National Provider Identifier
1952365199
Registry record updated Jul 1, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular Surgery PhysicianTaxonomy code 2086S0129X
License
227885 Issued in NY
Practice address
1 Atwell Rd
Cooperstown, NY 13326-1301
Phone
(607) 547-3474
Fax
(607) 547-6553
NPI assigned
Apr 14, 2006
Last updated
Jul 1, 2008By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 1, 2008

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 227885 NY
Vascular Surgery Physician 2086S0129X 227885 NY Primary

Addresses

Primary practice location

1 Atwell Rd
Cooperstown, NY 13326-1301

Mailing address

PO Box 725
Cooperstown, NY 13326-0725
Phone (607) 547-3474

Other identifiers 1

IdentifierTypeStateIssuer
02391968MedicaidNY

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
I20101101000758 NY Practitioner - Vascular Surgery 3779526892 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Vascular Surgery
Education
Indiana University School of Medicine, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Mary Imogene Bassett HospitalGroup PAC ID 3779488325, 780 clinicians

Practice addresses (Care Compare)

1 Associate Dr
Oneonta, NY 13820-2266
Phone (607) 433-6300

1 Atwell Rd
Cooperstown, NY 13326-1394

140 Burwell St
Little Falls, NY 13365-1725
Phone (315) 823-1000

178 Grandview Dr
Cobleskill, NY 12043-5144
Phone (518) 254-3456

2031 Dream Catcher PLZ
Oneida, NY 13421-2729
Phone (315) 231-5400

321 E Albany St
Herkimer, NY 13350-2016
Phone (315) 867-2700

Greystone Commercial Park
4580 State Route 28
Milford, NY 13807-1147
Phone (607) 547-7646

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Spinal fusion1-10
Varicose vein removal1-10
Melanoma (skin cancer) excision1-10
Leg revascularization (restoring blood flow)12
Removal of tissue24
Removal of skin lesions1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
227885NYMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mary Imogene Bassett Hospital CurrentSince May 27, 2003 Accepting new patients
Mary Imogene Bassett Hospital CurrentSince May 27, 2003 Accepting new patients
Mary Imogene Bassett Hospital Past Accepting new patients

Locations

178 Grandview Dr
Cobleskill, NY 12043
Phone (518) 254-3456

1 Atwell Rd
Cooperstown, NY 13326
Phone (607) 547-3480

460 Andes Rd
Delhi, NY 13753
Phone (607) 746-0300

140 Burwell St
Little Falls, NY 13365
Phone (315) 823-1000

130 North St
Walton, NY 13856
Phone (607) 865-6541

Interoperability endpoints

  • Direct secure messaging: scooper5934@bassett.direct-ci.net

Organizations & group practices 6

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 6

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": "1144972800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1214870400000",
    "number": "1952365199",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 725",
            "city": "COOPERSTOWN",
            "state": "NY",
            "postal_code": "133260725",
            "telephone_number": "607-547-3474",
            "fax_number": "607-547-6553"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 ATWELL RD",
            "city": "COOPERSTOWN",
            "state": "NY",
            "postal_code": "133261301",
            "telephone_number": "607-547-3474",
            "fax_number": "607-547-6553"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COOPER",
        "first_name": "SHELBY",
        "middle_name": "S",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-14",
        "last_updated": "2008-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "NY",
            "license": "227885",
            "primary": false
        },
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "NY",
            "license": "227885",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02391968",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cooperstown, NY

Sources for this page

Verify at the official NPI Registry.