PAUL J COPPOLA MD
NPI 1598763997
Obstetrics & Gynecology - Gynecology in Madison, CT
NPI Status: Active since July 09, 2005
Contact Information
145 DURHAM RD
SUITE 1
MADISON, CT
ZIP 06443
Phone: (203) 245-8035
Fax: (203) 245-4315
- Individual
- Male
- Obstetrics & Gynecology
- Gynecology
- PECOS Enrolled
- Opted-Out Medicare
About PAUL COPPOLA
This page provides the complete NPI Profile along with additional information for Paul Coppola, a women's health care provider established in Madison, Connecticut with a medical specialization in Obstetrics & Gynecology, focusing in gynecology . The healthcare provider is registered in the NPI registry with number 1598763997 assigned on July 2005. The practitioner's primary taxonomy code is 207VG0400X with license number 015953 (CT). The provider is registered as an individual and his NPI record was last updated 14 years ago.
- NPI
- 1598763997
- Provider Name
- PAUL J COPPOLA MD
- Gender
- Male
- Entity Type
- Individual
- Location Address
- 145 DURHAM RD SUITE 1 MADISON, CT 06443
- Location Phone
- (203) 245-8035
- Location Fax
- (203) 245-4315
- Mailing Address
- 340 MAIN ST STE 670 WORCESTER, MA 01608
- Mailing Phone
- (508) 754-3566
- Mailing Fax
- (203) 245-4315
- Is Sole Proprietor?
- No
- Enumeration Date
- 07-09-2005
- Last Update Date
- 10-05-2011
- Code Navigator
Women's health care providers like Paul Coppola treat and diagnose diseases and conditions that affect a woman's physical and emotional health. Women's health professionals come from a variety of different specialties, including obstetrician/gynecologists, general surgeons, perinatologists, physician assistants, nurse practitioners or nurse midwives. A women's health provider might help you with family planning, breast care, pregnancy and child birth, osteoporosis, menopause, heart disease, etc.
The provider doesn't accept Medicare and has signed an affidavit to be excluded from the Medicare program. If you are a Medicare beneficiary this means a provider can charge whatever they want for services rendered but must follow certain rules to do so. Paul Coppola opted out of Medicare effective on 02-01-2017 until 02-01-2025. Opt out periods last for two years and cannot be terminated unless the provider is opting out for the very first time and the affidavit is terminated no later than 90 days after the opt out effective date. Opt-out affidavits might renew automatically renew every two years. The provider opted out of Medicare but is permitted to order and refer services to other healthcare providers.
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Obstetrics & Gynecology Gynecology
- Taxonomy Code
- 207VG0400X
- Type
- Allopathic & Osteopathic Physicians
- License No.
- 015953
- License State
- CT
- Taxonomy Description
- A physician who specializes in diagnosis, treatment, and management of patients with gynecologic conditions. Source: National Uniform Claim Committee
Secondary Taxonomies
The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.
| No. | Taxonomy Code | Type | Classification / Specialization |
License No. (State) |
|---|---|---|---|---|
| 1 | 207VE0102X | Allopathic & Osteopathic Physicians | Obstetrics & Gynecology | 015953 (CT) |
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
Additional Identifiers
The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.
| Identifier | Type / Code | Identifier State | Identifier Issuer |
|---|---|---|---|
| 160000318 | MEDICARE ID-TYPE UNSPECIFIED (04) | CT | |
| B84171 | MEDICARE UPIN (02) | ||
| 001159532 | MEDICAID (05) | CT | |
| 160000318 | MEDICARE PIN (08) | CT |
Medicare Participation & PECOS Enrollment Status
Paul Coppola is enrolled in PECOS and is eligible to order or refer health care services for Medicare patients. The provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.
What is PECOS?
PECOS is the online Medicare enrollment management system or Provider, Enrollment, Chain and Ownership System. The PECOS system is a database of providers who have registered with CMS as providers or suppliers. PECOS is the primary source of information about verified Medicare professionals. Providers that want to participate in this program need to enroll in PECOS with their NPI number to avoid denied claims.
Is the provider registered in PECOS? Yes
Opted-Out of Medicare? Yes
Opt-Out Effective Date: 02-01-2017
Opt-Out End Date: 02-01-2025
Eligible to Order and Refer? Yes
Eligible to Order or Refer Part B Clinical Laboratory and Imaging: Yes
Eligible to Order or Refer Durable Medical Equipment (DMEPOS): Yes
Eligible to Order or Refer a Home Health Agency (HHA): Yes
Eligible to Order or Refer Power Mobility Devices: Yes
Physician Visit Costs
The pricing information below displays the copayment minimum, maximum and average amount that patients under Medicare are charged when visiting this provider as a new or established patient. Please keep in mind that these prices are just for reference purposes, and the actual prices charged by the provider might be different.
For patients covered under private health plans the prices below are also useful as healthcare pricing for private insurance is usually established as a function of Medicare prices. Private insurance covered patients should check their individual plans to determine the exact pricing.
The prices below reflect the costs for new and established patients in the 06443 ZIP code area.
New Patients Visit Costs *
The most utilized procedure code for new patients office visits is 99204
- Average New Patient Price $138.84
- Minimum New Patient Price $60.82
- Maximum New Patient Price $183.1
- Average New Patient Copayment $34.71
- Minimum New Patient Copayment $15.2
- Maximum New Patient Copayment $45.77
Established Patients Visit Costs *
The most utilized procedure code for established patients office visits is 99213
- Average Established Patient Price $75.55
- Minimum Established Patient Price $19.76
- Maximum Established Patient Price $149.26
- Average Established Patient Copayment $18.88
- Minimum Established Patient Copayment $4.94
- Maximum Established Patient Copayment $37.31
* The physician office visit costs information is generated by statistical analysis of similar providers in the same geographical area. The pricing information above IS NOT the amount charged by this provider.
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NPI Validation Check Digit Calculation
The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.
| Start with the original NPI number, the last digit is the check digit and is not used in the calculation. | |||||||||
| 1 | 5 | 9 | 8 | 7 | 6 | 3 | 9 | 9 | 7 |
| Step 1: Double the value of the alternate digits, beginning with the rightmost digit. | |||||||||
| 2 | 5 | 18 | 8 | 14 | 6 | 6 | 9 | 18 | |
| Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24. | |||||||||
| 2 + 5 + 1 + 8 + 8 + 1 + 4 + 6 + 6 + 9 + 1 + 8 + 24 = 83 | |||||||||
| Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit. | |||||||||
| 90 - 83 = 7 | 7 | ||||||||
The NPI number 1598763997 is valid because the calculated check digit 7 using the Luhn validation algorithm matches the last digit of the original NPI number.
Other Providers at the Same Location
The following 13 providers are registered at the same or nearby location.
PAUL J. COPPOLA, MD, PC
Obstetrics & Gynecology
(Gynecology)
145 DURHAM RD
STE 1
MADISON, CT
ZIP 06443
MR. STEVEN G BARASZ DDS
Dentist
145 DURHAM RD
OAK PARK PROF OFC SUITE #7
MADISON, CT
ZIP 06443
DR. SHARI A ROGUSKI D.C.
Chiropractor
(Nutrition)
145 DURHAM RD
SUITE 6
MADISON, CT
ZIP 06443
DR. KATHERINE E BLACK-LEE DPM
Podiatrist
145 DURHAM RD
MADISON, CT
ZIP 06443
DR. TERESE M NASER D.C.
Chiropractor
(Nutrition)
145 DURHAM RD
MADISON, CT
ZIP 06443
SOUTHERN CT CHRISTIAN NETWORK
Psychiatry & Neurology
(Forensic Psychiatry)
145 DURHAM RD
MAILBOX 7
MADISON, CT
ZIP 06443
DAVID J. GOLDEN, DPM, LLC
Podiatrist
(Foot Surgery)
145 DURHAM RD
MADISON, CT
ZIP 06443
DK CONSULTANTS LLC
Psychiatry & Neurology
(Psychiatry)
145 DURHAM RD
BOX 7 SUITE 10
MADISON, CT
ZIP 06443
SHARI A. ROGUSKI DC, LLC
Chiropractor
145 DURHAM RD
SUITE 6
MADISON, CT
ZIP 06443
JESSICA ROBISON M.S., CCC-SLP
Speech-Language Pathologist
145 DURHAM RD
SUITE 9
MADISON, CT
ZIP 06443
CAITLIN BRACALE MOT, OTR/L
Occupational Therapist
145 DURHAM RD
MADISON, CT
ZIP 06443
KAITLYN DEFELICE
Behavior Analyst
145 DURHAM RD
MADISON, CT
ZIP 06443
DR. STEPHANIE GILFOY ND
Naturopath
145 DURHAM RD
SUITE 1
MADISON, CT
ZIP 06443
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1598763997, enumerated as an "individual" on July 09, 2005.
The provider is located at 145 DURHAM RD SUITE 1 MADISON, CT 06443 and the phone number is (203) 245-8035.
Obstetrics & Gynecology with taxonomy code 207VG0400X and a focus in Gynecology.
The provider might be accepting Accepts: Medicare and Medicaid. Please consult your insurance carrier or call the provider to verify.
