Individual provider Active NPI

Simona Iustina Lupu, MD

  • Anesthesiology Physician
  • Boston, MA
National Provider Identifier
1053799296
Registry record updated Aug 10, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
A145724 Issued in CA
Practice address
55 Fruit St
Boston, MA 02114-2621
Phone
(617) 726-2000
NPI assigned
May 8, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 10, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X A145724 CA Primary

Addresses

Primary practice location

55 Fruit St
Boston, MA 02114-2621

Mailing address

274 Brittany LN
Saline, MI 48176-8914
Phone (734) 649-3541

Other practice location 1

11234 Anderson St
Loma Linda, CA 92350-1716
Phone (909) 558-4000

Other practice location 2

1500 E Medical Center Dr
Ann Arbor, MI 48109-5000
Phone (734) 936-4000

Other practice location 3

11234 Anderson St Rm 2532
Loma Linda, CA 92354-2804
Phone (909) 558-4475

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA, MA2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20200714002087 CA Practitioner - AnesthesiologyPractitioner - Critical Care (Intensivists) 2668895350 Reassigns benefits to 1 organization
I20221019003220 MA Practitioner - Anesthesiology 2668895350 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
Loma Linda University School of Medicine, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Massachusetts General Physicians Organization IncGroup PAC ID 2466365820, 3,494 clinicians

Practice addresses (Care Compare)

55 Fruit St
Boston, MA 02114-2696
Phone (617) 724-0287

Hospital & facility affiliations

  • Massachusetts General Hospital Hospital, Boston, MA, CCN 220071

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
General Hospital Corp Current Accepting new patients
Massachusetts General Physicians Organization Inc CurrentSince Sep 1, 2022 Accepting new patients
The General Hospital Corporation CurrentSince Sep 1, 2022 Accepting new patients
Faculty Physicians and Surgeons of Llusm Current Accepting new patients
Faculty Physicians and Surgeons of Llusm Anesthesiology CurrentSince Aug 1, 2020 Accepting new patients

Locations

11234 Anderson St
Rm 2532
Loma Linda, CA 92350
Phone (909) 558-4475

11370 Anderson St
#B100
Loma Linda, CA 92354
Phone (909) 558-2848

11234 Anderson St
Loma Linda, CA 92350
Phone (909) 558-3016

11234 Anderson St
#A600
Loma Linda, CA 92350
Phone (909) 558-2824

File Number 54701
Los Angeles, CA 90074
Phone (909) 651-4300

55 Fruit St
Boston, MA 02114

55 Fruit St
#2
Boston, MA 02114
Phone (617) 726-2967

Interoperability endpoints

  • Direct secure messaging: slupu62117@direct.llu.edu
  • Direct secure messaging: lupu.simona.mgh@direct.partners.masshiway.net

Organizations & group practices 5

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1431043200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660089600000",
    "number": "1053799296",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "274 BRITTANY LN",
            "city": "SALINE",
            "state": "MI",
            "postal_code": "481768914",
            "telephone_number": "734-649-3541"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "55 FRUIT ST",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021142621",
            "telephone_number": "617-726-2000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "11234 Anderson St",
            "address_purpose": "LOCATION",
            "city": "Loma Linda",
            "state": "CA",
            "postal_code": "923501716",
            "country_code": "US",
            "telephone_number": "909-558-4000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1500 E Medical Center Dr",
            "address_purpose": "LOCATION",
            "city": "Ann Arbor",
            "state": "MI",
            "postal_code": "481095000",
            "country_code": "US",
            "telephone_number": "734-936-4000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "11234 Anderson St Rm 2532",
            "address_purpose": "LOCATION",
            "city": "Loma Linda",
            "state": "CA",
            "postal_code": "923542804",
            "country_code": "US",
            "telephone_number": "909-558-4475",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LUPU",
        "first_name": "SIMONA",
        "middle_name": "IUSTINA",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-05-08",
        "last_updated": "2022-08-10",
        "certification_date": "2022-08-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "CA",
            "license": "A145724",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boston, MA

Sources for this page

Verify at the official NPI Registry.