Physician Compare National (NPI:1922081900)

HEALTHCARE PROVIDER: GERALD MAX KOPPES MD

Physician Compare National contains general information about individual eligible professionals (EPs) such as demographic information and Medicare quality program participation.

Individual Professional Information
NPI	1922081900
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	6608960935
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20100825000663
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	KOPPES
	Individual professional last name
Provider First Name	GERALD
	Individual professional first name
Provider Middle Name	M
	Individual professional middle name
Provider Gender	M
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	UNIVERSITY OF KANSAS SCHOOL OF MED (KC/WICH/SAL)
	Individual professional's medical school
Graduation Year	1972
	Individual professional's medical school graduation year
Primary Specialty	CARDIOVASCULAR DISEASE (CARDIOLOGY)
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Line 1 Street Address	1303 MCCULLOUGH AVE
	Group Practice or individual's line 1 address
Line 2 Street Address	SUITE 300
	Group Practice or individual's line 2 address
City	SAN ANTONIO
	Group Practice or individual's city
State	TX
	Group Practice or individual's state
Zip Code	782125605
	Group Practice or individual's zip code (9 digits when available)

Hospital(s) Affiliation Information
Hospital Affiliation CCN 1	670055
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	METHODIST STONE OAK HOSPITAL
	Legal business name of hospital where individual professional provides service 1
Professional Accepts Medicare Assignment	Y