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BERT ANTHONY COPPOTELLI MD
NPI 1629070941
Family Medicine in Lisbon, CT

Active since June 01, 2005CLIA 07D0936018 · Waiver
2 LEE RD, LISBON, CT 06351(860) 376-4451(860) 376-5977 Get Directions Write a Review

NPPES record last updated: September 5, 2007. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Bert Anthony Coppotelli Md NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

BERT ANTHONY COPPOTELLI MD (NPI 1629070941) is an individual family medicine provider in Lisbon, Connecticut, licensed in Connecticut (26684) and active in the NPI registry since June 2005. He holds a CLIA Waiver certificate valid through November 12, 2027.

NPPES Registry Identity

NPI1629070941
Entity TypeIndividualMale
Primary Taxonomy207Q00000X
Provider Legal NameBERT ANTHONY COPPOTELLICredential: MD
Location Address2 LEE RDLisbon, CT 06351-3015
Mailing Address2 Lee RdLisbon, CT 06351-3015 · (860) 376-4451 · Fax (860) 376-5977
Phone(860) 376-4451
Fax(860) 376-5977
Sole ProprietorNo
Enumeration DateJune 1, 2005
Last NPPES UpdateSeptember 5, 2007
✔ NPI 1629070941 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
License✔ Licensed in CT · 26684
Definition
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.
2 LEE RD, Lisbon, CT 06351
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Other Identifiers 8

Medicaid001266840CT
Other010621809Tid#
Other00126684004Bcbs
Medicare UPINB84337
Other010621809Unhc
Medicare ID-Type Unspecified080001532
Other010621809Cigna
Other2V1389Healthnet

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 07D0936018

Bert Coppotelli MD LLC · Lisbon, CT
Active · expires Nov 12, 2027
CLIA Number07D0936018
Laboratory TypePhysician Office
Certificate Effective DateNovember 13, 2025
Certificate Expiration DateNovember 12, 2027
Laboratory DirectorBert Coppotelli MD
Laboratory Phone(860) 376-4451
Laboratory LocationBert Coppotelli MD LLC2 Lee Road, Lisbon, CT 06351
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 5

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MARK DAVID DEPONTE MD
Family Medicine
2 LEE RD
LISBON, CT 06351
Southeastern Connecticut Planning Region (860) 376-4451
MELANIE I HOPKINS PA-C
Physician Assistant (Medical)
2 LEE RD
LISBON, CT 06351
Southeastern Connecticut Planning Region (860) 376-4451
MARK D. DEPONTE, M.D.,LLC
Family Medicine
2 LEE RD
LISBON, CT 06351
Southeastern Connecticut Planning Region (860) 376-4451
BERT COPPOTELLI MD LLC
Family Medicine
2 LEE RD
LISBON, CT 06351
Southeastern Connecticut Planning Region (860) 376-4451
CYNTHIA BOOTH LORD PA-C
Physician Assistant (Medical)
2 LEE RD
LISBON, CT 06351
Southeastern Connecticut Planning Region (860) 376-4451

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Bert Coppotelli's NPI number?

The NPI number for Bert Coppotelli is 1629070941. It was assigned to this individual provider in the NPPES registry on June 1, 2005.

Where is Bert Coppotelli located?

Bert Coppotelli practices at 2 Lee Rd, Lisbon, CT 06351. The listed phone number is (860) 376-4451.

What is Bert Coppotelli's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Does Bert Coppotelli hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 07D0936018) is associated with this NPI, valid through November 12, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Bert Coppotelli was last updated on September 5, 2007. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.