Individual provider Active NPI

Brittany Erin Schupbach, PA

  • Physician Assistant
  • Plano, TX
National Provider Identifier
1063843944
Registry record updated Dec 3, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA08706 Issued in TX
Practice address
5044 Tennyson Pkwy Ste B
Plano, TX 75024-2953
Phone
(972) 985-9003
Fax
(972) 985-1176
NPI assigned
Dec 3, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 3, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA08706 TX Primary

Addresses

Primary practice location

5044 Tennyson Pkwy Ste B
Plano, TX 75024-2953

Mailing address

5044 Tennyson Pkwy Ste B
Plano, TX 75024-2953
Phone (972) 985-9003

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140703001706 TX Practitioner - Physician Assistant 8325263437 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Texas Tech University Health Science Center School of Medicine, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Oliver Street 5.01(a) IncGroup PAC ID 0042464125, 169 clinicians

Practice addresses (Care Compare)

1367 Dominion PLZ
Tyler, TX 75703-1013
Phone (903) 534-6200

4701 Medical Ctr Dr
Suite 1B
McKinney, TX 75069-1831
Phone (972) 985-9003

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as individual
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA08706TXMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Dermatology Associates Past Accepting new patients

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

Organizations & group practices 2

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": "1386028800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1386028800000",
    "number": "1063843944",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5044 TENNYSON PKWY STE B",
            "city": "PLANO",
            "state": "TX",
            "postal_code": "750242953",
            "telephone_number": "972-985-9003",
            "fax_number": "972-985-1176"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5044 TENNYSON PKWY STE B",
            "city": "PLANO",
            "state": "TX",
            "postal_code": "750242953",
            "telephone_number": "972-985-9003",
            "fax_number": "972-985-1176"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHUPBACH",
        "first_name": "BRITTANY",
        "middle_name": "ERIN",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-12-03",
        "last_updated": "2013-12-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA08706",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Plano, TX

Sources for this page

Verify at the official NPI Registry.