Individual provider Active NPI

Thomas Douglass Juopperi, PHYSICIAN ASSISTANT

  • Physician Assistant
  • Burlington, NC
National Provider Identifier
1972782159
Registry record updated Dec 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
0010-11530 Issued in NC
Practice address
104 Huffman Mill Rd
Burlington, NC 27215-5113
Phone
(336) 506-1720
NPI assigned
Oct 24, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 18, 2024

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 3887 CO
Physician Assistant 363A00000X 0010-11530 NC Primary

Addresses

Primary practice location

104 Huffman Mill Rd
Burlington, NC 27215-5113

Mailing address

PO Box 2521
Durham, NC 27715-2521
Phone (719) 244-4619

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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
I20220408001107 NC Practitioner - Physician Assistant 7113001322 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Fastmed PCGroup PAC ID 9830540558, 174 clinicians

Practice addresses (Care Compare)

104 Huffman Mill Rd
Burlington, NC 27215-5113
Phone (336) 506-1720

1261 Julian Allsbrk Hwy
Roanoke Rapids, NC 27870-5127
Phone (252) 537-5600

1361 Klumac Rd
Salisbury, NC 28147-9086
Phone (704) 603-1175

220 US 70 Hwy W
Garner, NC 27529-3943
Phone (919) 779-7890

310 S Stratford Rd
Suite 120
Winston Salem, NC 27103-1820
Phone (336) 714-5399

3215 Battleground Ave
Greensboro, NC 27408-2603
Phone (336) 387-5020

391 George W Liles Pkwy NW
Concord, NC 28027-8218
Phone (704) 886-1780

7010 NC Hwy 751
Durham, NC 27707-5733
Phone (919) 313-3900

724 S Horner Blvd
Sanford, NC 27330-4822
Phone (919) 776-6767

903 S Beckford Dr
Henderson, NC 27536-5908
Phone (252) 654-1020

910 N Madison Blvd
Suite B
Roxboro, NC 27573-4573
Phone (336) 592-2230

Merit-based Incentive Payment System (MIPS)

Final score
74.09 of 100Reported as group
Quality
65.78
Improvement activities
40
Cost
76.37

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
3887COMDFamily Medicine Physician
0010-11530NCMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Fastmed Primary Care, P.C. Past Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1193184000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1734480000000",
    "number": "1972782159",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2521",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277152521",
            "telephone_number": "719-244-4619"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "104 HUFFMAN MILL RD",
            "city": "BURLINGTON",
            "state": "NC",
            "postal_code": "272155113",
            "telephone_number": "336-506-1720"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JUOPPERI",
        "first_name": "THOMAS",
        "middle_name": "DOUGLASS",
        "name_prefix": "Mr.",
        "credential": "PHYSICIAN ASSISTANT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-10-24",
        "last_updated": "2024-12-18",
        "certification_date": "2024-12-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CO",
            "license": "3887",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "0010-11530",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Burlington, NC

Sources for this page

Verify at the official NPI Registry.