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BERT ANTHONY COPPOTELLI MD NPI 1629070941


NPI Information

NPI: 1629070941
Provider Name: BERT ANTHONY COPPOTELLI, MD
Classification: Family Medicine - 207Q00000X
Entity Type: Individual

PECOS Registration: Yes

CLIA Number: 07D0936018

Address:
2 LEE RD
LISBON, CT
ZIP 06351
Phone: (860) 376-4451
Get Directions

Bert Anthony Coppotelli, MD is a family medicine in Lisbon, CT. The provider is family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. Bert Anthony Coppotelli, MD NPI is 1629070941. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

2 LEE RD
LISBON, CT
ZIP 06351-015
Phone: (860) 376-4451
Fax: (860) 376-5977

The NPI 1629070941 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 CLIA number assigned to this NPI record is 07D0936018 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 6/1/2005 and was last updated on 9/5/2007.


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
1207Q00000XFamily Medicine26684CONNECTICUTYes

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
1001266840MEDICAIDCONNECTICUT
2010621809OTHERTID#
300126684004OTHERBCBS
4B84337MEDICARE UPIN
5010621809OTHERUNHC
6080001532MEDICARE ID-TYPE UNSPECIFIED
7010621809OTHERCIGNA
82V1389OTHERHEALTHNET

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.