Active NPI
Kathleen Chupka, PT
- Physical Medicine & Rehabilitation Physician
- Kingston, PA
National Provider Identifier
1013549963
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Medicine & Rehabilitation Physician
- License
- PT006313L
- Practice address
- 256 Schuyler Ave
Kingston, PA 18704-3322 - Phone
- (570) 283-5917
- NPI assigned
- Feb 9, 2020
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Medicine & Rehabilitation Physician | 208100000X | PT006313L | PA | Primary |
Addresses
Primary practice location
256 Schuyler Ave
Kingston, PA 18704-3322
Mailing address
70 E Overbrook Rd
Shavertown, PA 18708-1111
Phone (570) 690-6786
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in PA
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20240215000388 | PA | Practitioner - Physical Therapist in Private Practice | 9133563497 | Reassigns benefits to 1 organization |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Associated Family Home Care Inc | Current | Accepting new patients |
Locations
256 Schuyler Ave
Kingston, PA 18704
Phone (570) 283-5917
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1581206400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1581206400000",
"number": "1013549963",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "70 E OVERBROOK RD",
"city": "SHAVERTOWN",
"state": "PA",
"postal_code": "187081111",
"telephone_number": "570-690-6786"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "256 SCHUYLER AVE",
"city": "KINGSTON",
"state": "PA",
"postal_code": "187043322",
"telephone_number": "570-283-5917"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CHUPKA",
"first_name": "KATHLEEN",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-02-09",
"last_updated": "2020-02-09",
"certification_date": "2020-02-09",
"status": "A"
},
"taxonomies": [
{
"code": "208100000X",
"taxonomy_group": "",
"desc": "Physical Medicine & Rehabilitation",
"state": "PA",
"license": "PT006313L",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Kingston, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 9, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.