Individual provider Active NPI

Alexis Schupp, DPM

  • Podiatrist
  • Pittsburgh, PA
National Provider Identifier
1053803973
Registry record updated Sep 16, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
01741 Issued in MD
Practice address
1400 Locust St
Building B. Room 9520
Pittsburgh, PA 15219
Phone
(412) 647-4279
NPI assigned
Jun 6, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 16, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Podiatrist 213E00000X 01741 MD Primary

Addresses

Primary practice location

1400 Locust St
Building B. Room 9520
Pittsburgh, PA 15219

Mailing address

3600 Forbes Avenue
Forbes Tower - Plaza Level Suite 140
Pittsburgh, PA 15213

Electronic endpoints 2

TypeEndpointUseAffiliation
SOAP URL https://careepiceast.kp.org:14430/Interconnect-prodmam/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ceq Health Information Exchange (HIE)
SOAP URL https://careepiceast.kp.org:14430/Interconnect-prodmam/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ceq Health Information Exchange (HIE)

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC, MD2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20220914001548 DC Practitioner - Podiatry 3779968532 Reassigns benefits to 5 organizations
I20220926002657 MD Practitioner - Podiatry 3779968532 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
California School of Podiatric Medicine, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Kaiser Foundation Health Plan of the Mid Atlantic States, IncGroup PAC ID 3779495858, shared by 17 NPIs, 1,921 clinicians

Practice addresses (Care Compare)

10810 Connecticut Ave
Kensington, MD 20895-2138
Phone (301) 929-7100

1221 Mercantile LN
Largo, MD 20774-5374
Phone (301) 618-5700

2391 Greenspring Dr
Timonium, MD 21093-6038
Phone (301) 816-2424

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue1-10
Removal of nail tissue1-10
Removal or shaving of skin growth1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Kaiser Foundation Health Plan of the Mid Atlantic States, Inc CurrentSince Sep 6, 2022 Accepting new patients
Kaiser Foundation Health Plan of the Mid Atlantic States, Inc CurrentSince Sep 6, 2022 Accepting new patients
Kaiser Foundation Health Plan of the Mid Atlantic States, Inc Current Accepting new patients
Kaiser Foundation Health Plan of the Mid Atlantic States, Inc CurrentSince Sep 6, 2022 Accepting new patients
Kaiser Foundation Health Plan of the Mid Atlantic States, Inc CurrentSince Sep 6, 2022 Accepting new patients
Kaiser Foundation Health Plan of the Mid Atlantic States, Inc CurrentSince Sep 6, 2022 Accepting new patients
Kaiser Foundation Health Plan of the Mid Atlantic States, Inc Podiatrist Current Accepting new patients
Kaiser Foundation Health Plan of the Mid Atlantic States, Inc CurrentSince Sep 6, 2022 Accepting new patients
Kaiser Foundation Health Plan of the Mid Atlantic States, Inc CurrentSince Sep 6, 2022 Accepting new patients
Kaiser Foundation Health Plan of the Mid Atlantic States, Inc CurrentSince Sep 6, 2022 Accepting new patients

Locations

7070 Samuel Morse Dr
Columbia, MD 21046
Phone (410) 309-4600

7190 Crestwood Blvd
Frederick, MD 21703
Phone (240) 529-1700

1701 Twin Springs Rd
Halethorpe, MD 21227
Phone (410) 737-5000

10810 Connecticut Ave
Kensington, MD 20895
Phone (301) 929-7100

1221 Mercantile Ln
Fl 3
Largo, MD 20774
Phone (301) 618-5500

655 Watkins Mill Rd
Montgomery Village, MD 20879
Phone (301) 929-7100

2101 E Jefferson St
#4E
Rockville, MD 20852

2101 E Jefferson St
Ste 6WPPQA
Rockville, MD 20852
Phone (301) 816-5853

2391 Greenspring Dr
Timonium, MD 21093
Phone (410) 847-3000

6701 N Charles St
Towson, MD 21204
Phone (443) 849-2000

1221 Mercantile Ln
Upper Marlboro, MD 20774
Phone (301) 618-5500

8008 Westpark Dr
Tysons Corner, VA 22102
Phone (703) 287-6400

Organizations & group practices 10

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": "1528243200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1663286400000",
    "number": "1053803973",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3600 FORBES AVENUE",
            "address_2": "FORBES TOWER - PLAZA LEVEL SUITE 140",
            "city": "PITTSBURGH",
            "state": "PA",
            "postal_code": "15213"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1400 LOCUST ST",
            "address_2": "BUILDING B. ROOM 9520",
            "city": "PITTSBURGH",
            "state": "PA",
            "postal_code": "15219",
            "telephone_number": "412-647-4279"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHUPP",
        "first_name": "ALEXIS",
        "name_prefix": "Dr.",
        "credential": "DPM",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-06-06",
        "last_updated": "2022-09-16",
        "certification_date": "2022-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "MD",
            "license": "01741",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepiceast.kp.org:14430/Interconnect-prodmam/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ceq",
            "affiliation": "N",
            "endpointDescription": "Carequality",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "1400 Locust St",
            "address_2": "Building B. Room 9520",
            "city": "Pittsburgh",
            "state": "PA",
            "country_code": "US",
            "postal_code": "15219",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepiceast.kp.org:14430/Interconnect-prodmam/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ceq",
            "affiliation": "N",
            "endpointDescription": "Carequality",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "1400 Locust St",
            "address_2": "Building B. Room 9520",
            "city": "Pittsburgh",
            "state": "PA",
            "country_code": "US",
            "postal_code": "15219",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Pittsburgh, PA

Sources for this page

Verify at the official NPI Registry.