ELISABETH MARTA KUPER MD
NPI 1952509457
Family Medicine in Silverthorne, CO

NPI Status: Active since July 05, 2007

Contact Information

265 TANGLEWOOD LN, E1
SILVERTHORNE, CO
ZIP 80498
Phone: (970) 468-1003
Fax: (970) 262-2196

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  • Individual
  • Female
  • Years of Experience 18
  • Family Medicine
  • PECOS Enrolled
  • Accepts Medicare Approved Payment

About ELISABETH KUPER

Elisabeth Kuper is a primary care provider established in Silverthorne, Colorado and her medical specialization is Family Medicine with more than 18 years of experience. She graduated from Washington University School Of Medicine in 2007. The healthcare provider is registered in the NPI registry with number 1952509457 assigned on July 2007. The practitioner's primary taxonomy code is 207Q00000X with license number M-10576 (ID). The provider is registered as an individual and her NPI record was last updated 9 years ago.

NPI
1952509457
Provider Name
ELISABETH MARTA KUPER MD
Gender
Female
Entity Type
Individual
Location Address
265 TANGLEWOOD LN, E1 SILVERTHORNE, CO 80498
Location Phone
(970) 468-1003
Location Fax
(970) 262-2196
Mailing Address
PO BOX 1292 FRISCO, CO 80443
Mailing Phone
(970) 668-1791
Mailing Fax
(970) 262-2196
Medical School Name
WASHINGTON UNIVERSITY SCHOOL OF MEDICINE
Graduation Year
2007
Is Sole Proprietor?
No
Enumeration Date
07-05-2007
Last Update Date
04-17-2015
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A primary care provider (PCP) like Elisabeth Kuper sees people with common medical problems. The primary care provider might be a doctor, physician assistant, nurse practitioner or clinic that are usually involved in your long-term care. A PCP might provide preventive care, treat common medical conditions, identify urgent medical problems and refer you to specialists when necessary. Primary care is usually provided in an outpatient facility but if you are admitted to a hospital your PCP may assist in your care. The most common medical conditions seen by primary care providers are: hypertension, upper respiratory tract infections, depression or anxiety, back pain, arthritis, dermatitis, diabetes, urinary tract infections, etc

Elisabeth Kuper is registered with Medicare and accepts claims assignment, this means the provider accepts the approved amount for the cost of rendered services as full payment. Participating providers may not charge beneficiaries more than the approved amount for their services. Please keep in mind that beneficiaries still have to pay a coinsurance or copayment amount for a visit or service.

The typical physician office visit costs for Medicare beneficiaries in this area are: $23.01 for a new patient copayment and $26.58 for an established patient copayment.

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

Family Medicine

Taxonomy Code
207Q00000X
Type
Allopathic & Osteopathic Physicians
License No.
M-10576
License State
ID
Taxonomy Description
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.

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)
1207Q00000XAllopathic & Osteopathic Physicians

Family Medicine

MR-0938 (ID)

Insurance Plans Accepted

According to publicly available information the provider might be accepting the following health plans from these health insurance companies:

  • Moda Health Plan, Inc.

    • Moda Health Affinity Bronze 7750 - EPO
    • Moda Health Affinity Bronze 9000 - EPO
    • Moda Health Affinity Bronze HSA 7500 - EPO
    • Moda Health Affinity Gold 1000 - EPO
    • Moda Health Affinity Gold 250 - EPO
    • Moda Health Affinity Silver 3500 - EPO
    • Moda Health Affinity Silver 4500 - EPO
    • Moda Health Affinity Silver 6400 - EPO
    • Moda Health Oregon Standard Bronze Plan (Affinity) - EPO
    • Moda Health Oregon Standard Gold (Affinity) - EPO
    • Moda Health Oregon Standard Silver (Affinity) - EPO
  • Mountain Health CO-OP

    • Connect Bronze Expanded - PPO
    • Connect Bronze Expanded Standard - PPO
    • Connect Bronze HDHP - PPO
    • Connect Catastrophic - PPO
    • Connect Gold - PPO
    • Connect Gold Standard - PPO
    • Connect Silver - PPO
    • Connect Silver Option 2 - PPO
    • Connect Silver Standard - PPO
    • High Plains Bronze HDHP - PPO
    • High Plains Bronze Standard Expanded - PPO
    • High Plains Gold - PPO
    • High Plains Gold HDHP - PPO
    • High Plains Gold Standard - PPO
    • High Plains Silver - PPO
  • Medicare

  • Medicaid


*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
1196321OTHER (01)IDMEDICARE PTAN
807773500MEDICAID (05)ID 

PECOS Enrollment and Medicare Participation Status

Elisabeth Kuper 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

  • PECOS PAC ID: 2466646484

    What is the PECOS Associate Control ID?
    A PAC ID is a unique 10-digit number assigned to an individual or organization healthcare provider in PECOS. The PAC ID is used to link together all the provider information, like tax identification numbers and organizational names. A PAC ID can be connected to multiple Enrollment IDs if an individual or organization has enrolled in PECOS more than once.

  • PECOS Enrollment ID: I20101103000476

    What is the Provider Enrollment ID?
    The Enrollment ID is a unique alphanumeric 15-digit code assigned to each new provider's PECOS enrollment application. The Enrollment ID is used to link together all the provider enrollment information like enrollment type, state, provider specialty, and reassignment of benefits.

  • Accepts Medicare Assignment? Yes

    What does it mean "accepts medicare assignment"?
    When a provider accepts Medicare assignment, the provider agrees to be paid directly by Medicare and to accept the payment amount approved by Medicare. Additionally, the provider agrees to not bill patients for more than the Medicare deductible and coinsurance amounts.
    A provider who doesn't accept assignment may charge you up to 15% over the Medicare-approved amount. This is known as the limiting charge. You may have to pay this amount, or it may be covered by another insurer.

  • 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

Provider Referred Orders for Durable Medical Equipment, Devices & Supplies

The following list reflects the services, supplies or durable medical equipment ordered by this provider to a DME supplier on behalf of patients. The information below is derived from Medicare claims data and reflects the BETOS category, HCPCS code information and the number times each service was submitted under the Medicare fee-for-service program.

Durable Medical Equipment

  • Other DME (D1E)

    Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips (HCPCS:A4253)

    5 DME suppliers used 15 Medicare Claims 38 Services Paid

  • Other DME (D1E)

    Continuous positive airway pressure (cpap) device (HCPCS:E0601)

    1 DME suppliers used 19 Medicare Claims 19 Services Paid

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 80498 ZIP code area.

New Patients Visit Costs *

The most utilized procedure code for new patients office visits is 99203

  • Average New Patient Price $92.04
  • Minimum New Patient Price $60.06
  • Maximum New Patient Price $181
  • Average New Patient Copayment $23.01
  • Minimum New Patient Copayment $15.01
  • Maximum New Patient Copayment $45.25

Established Patients Visit Costs *

The most utilized procedure code for established patients office visits is 99214

  • Average Established Patient Price $106.32
  • Minimum Established Patient Price $18.98
  • Maximum Established Patient Price $148.2
  • Average Established Patient Copayment $26.58
  • Minimum Established Patient Copayment $4.74
  • Maximum Established Patient Copayment $37.05

* 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.

Hospital Affiliations

Hospital affiliation is identified through self-reporting data, inpatient, outpatient, physician and ancillary service claims linked by the medical claims NPI number and place of service code. Additionally, to further determine provider hospital affiliation the clinician must have provided services to at least three patients on three different dates in the last 12 months. Elisabeth Kuper is affiliated with the following medical facilities:

Hospital Name Address Phone Hospital Type Overall Rating
ST LUKE'S REGIONAL MEDICAL CENTER190 EAST BANNOCK STREET
BOISE, ID 83712
(208) 381-2222Acute Care Hospitals
SAINT ALPHONSUS REGIONAL MEDICAL CENTER1055 NORTH CURTIS ROAD
BOISE, ID 83706
(208) 367-2121Acute Care Hospitals

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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.
1952509457
Step 1: Double the value of the alternate digits, beginning with the rightmost digit.
2910210018410
Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24.
2 + 9 + 1 + 0 + 2 + 1 + 0 + 0 + 1 + 8 + 4 + 1 + 0 + 24 = 53
Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit.
60 - 53 = 77

The NPI number 1952509457 is valid because the calculated check digit 7 using the Luhn validation algorithm matches the last digit of the original NPI number.

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1952509457, enumerated in the NPI registry as an "individual" on July 05, 2007

The provider is located at 265 Tanglewood Ln, E1 Silverthorne, Co 80498 and the phone number is (970) 468-1003

The provider's speciality is Family Medicine with taxonomy code 207Q00000X

The provider has more than 18 years of experience. She graduated from Washington University School Of Medicine in 2007.

The provider might be accepting Accepts: Moda Health Plan, Inc., Mountain Health CO-OP,. Please consult your insurance carrier or call the provider to make sure your health plan is currently accepted.

Yes, as of July 02, 2024 the provider is registered in PECOS and is eligible to order health care services or supplies for Medicare patients. If you are a beneficiary 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.

Medicare beneficiaries should expect a typical cost of $92.04 with an average copayment of $23.01 for new patient appointments. Established patients should expect a typical charge of $106.32 and an average copayment of 26.58. Please review your insurance plan or contact the provider directly to determine your specific costs.

The practitioner is affiliated to the following hospital(s): ST LUKE'S REGIONAL MEDICAL CENTER and SAINT ALPHONSUS REGIONAL MEDICAL CENTER. Hospital affiliations are identified through self-reporting data and service claims based on the place of service.

This NPI record was last updated on July 05, 2007. To officially update your NPI information contact the National Plan and Provider Enumeration System (NPPES) at 1-800-465-3203 (NPI Toll-Free) or by email at [email protected].
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