Individual provider Active NPI

David M Poppel, MD

  • Nephrology Physician
  • Springfield, MA
National Provider Identifier
1992787659
Registry record updated Mar 5, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
49681 Issued in MA
Practice address
100 Wason Ave
Suite 200
Springfield, MA 01107-1119
Phone
(413) 733-9666
Fax
(413) 750-3432
NPI assigned
Nov 17, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 5, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology Physician 207RN0300X 49681 MA Primary
Nephrology Physician 207RN0300X 025574 CT

Addresses

Primary practice location

100 Wason Ave
Suite 200
Springfield, MA 01107-1119

Mailing address

PO Box 70266
Springfield, MA 01107-1577
Phone (413) 788-6530

Other identifiers 3

IdentifierTypeStateIssuer
6172512MedicaidMA
0031000063MedicaidCT
02914267MedicaidNY

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

NPI Registry JSON

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

{
    "created_epoch": "1132185600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1393977600000",
    "number": "1992787659",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 70266",
            "city": "SPRINGFIELD",
            "state": "MA",
            "postal_code": "011071577",
            "telephone_number": "413-788-6530",
            "fax_number": "413-750-8027"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 WASON AVE",
            "address_2": "SUITE 200",
            "city": "SPRINGFIELD",
            "state": "MA",
            "postal_code": "011071119",
            "telephone_number": "413-733-9666",
            "fax_number": "413-750-3432"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POPPEL",
        "first_name": "DAVID",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-17",
        "last_updated": "2014-03-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "MA",
            "license": "49681",
            "primary": true
        },
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "CT",
            "license": "025574",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6172512",
            "state": "MA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0031000063",
            "state": "CT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02914267",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Springfield, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 5, 2014; 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.