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LUKE KOPULOS MD NPI 1245436013


NPI Information

NPI: 1245436013
Provider Name: LUKE KOPULOS, MD
Classification: Radiology - 2085R0202X
Entity Type: Individual

Specialization: Diagnostic Radiology

PECOS Registration: Yes

Address:
804 SERVICE ROAD
ROOM D100
EAST LALNSING, MI
ZIP 48824
Phone: (517) 355-5053
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Luke Kopulos, MD is a diagnostic radiology radiology in East Lalnsing, MI with 17 years of experience. The provider is a radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease. Luke Kopulos, MD NPI is 1245436013. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

Education
Medical School: UNIVERSITY OF CHICAGO, PRITZKER SCHOOL OF MEDICINE
Graduation Year:2007

The provider's business location address is:

804 SERVICE ROAD
ROOM D100
EAST LALNSING, MI
ZIP 48824-062
Phone: (517) 355-5053
Fax: (517) 432-4394

The NPI 1245436013 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 6/26/2007 and was last updated on 4/26/2021.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
12085R0202XRadiologyDiagnostic Radiology036-136931ILLINOISYes
22085R0202XRadiologyDiagnostic Radiology4301102549MICHIGANNo
3390200000XStudent in an Organized Health Care Education/Training Program125052708ILLINOISNo

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
11245436013MEDICAIDMICHIGAN

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.