Jason Kopenitz, DO | |
3735 Glenlake Dr Ste 250, Charlotte, NC 28208-6866 | |
(704) 749-5800 | |
(704) 626-3237 |
Full Name | Jason Kopenitz |
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Gender | Male |
Speciality | Anesthesiology |
Location | 3735 Glenlake Dr Ste 250, Charlotte, North Carolina |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1104323997 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207L00000X | Anesthesiology | 2022-00657 (North Carolina) | Primary |
207L00000X | Anesthesiology | 91310 (South Carolina) | Secondary |
Entity Name | Providence Anesthesiology Associates Pa |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1396739884 PECOS PAC ID: 3971566761 Enrollment ID: O20041111000930 |
Mailing Address | Practice Location Address |
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Jason Kopenitz, DO Po Box 117661, Atlanta, GA 30368-7661 Ph: (704) 749-5800 | Jason Kopenitz, DO 3735 Glenlake Dr Ste 250, Charlotte, NC 28208-6866 Ph: (704) 749-5800 |
Michael J Mcnelis, MD Anesthesiology Medicare: Medicare Enrolled Practice Location: 200 Providence Rd, Suite 101, Charlotte, NC 28207 Phone: 704-749-5800 Fax: 704-749-5819 | |
Dr. Bernard Velardo, MD Anesthesiology Medicare: Accepting Medicare Assignments Practice Location: 1000 Blythe Blvd, Charlotte, NC 28203 Phone: 704-355-2000 | |
Dr. Richard Ralph Pagano, MD Anesthesiology Medicare: Accepting Medicare Assignments Practice Location: 10628 Park Rd, Charlotte, NC 28210 Phone: 704-667-1000 | |
Dr. Kevin Todd Cortese, MD Anesthesiology Medicare: Medicare Enrolled Practice Location: 1000 Blythe Blvd, Charlotte, NC 28203 Phone: 704-355-2000 | |
Stephanie Francis Newby, MD Anesthesiology Medicare: Accepting Medicare Assignments Practice Location: 501 Billingsley Rd, Ste B, Charlotte, NC 28211 Phone: 704-444-2400 | |
Kelly Comolli Wilson, MD Anesthesiology Medicare: Medicare Enrolled Practice Location: 3735 Glenlake Dr Ste 250, Charlotte, NC 28208 Phone: 704-749-5800 | |
Norman A Holmes, MD Anesthesiology Medicare: Not Enrolled in Medicare Practice Location: 200 Providence Rd, Suite 101, Charlotte, NC 28207 Phone: 704-749-5800 Fax: 704-749-5819 |