Individual provider Active NPI

Heather Leah Hupp, PHYSICIAN ASSITANT

  • Physician Assistant
  • Cleveland, OH
National Provider Identifier
1083937338
Registry record updated Jul 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
50.006277RX Issued in OH
Practice address
1730 W 25TH St
Cleveland, OH 44113-3108
Phone
(216) 385-8051
NPI assigned
Mar 1, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 19, 2024

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 50.006277RX OH Primary

Addresses

Primary practice location

1730 W 25TH St
Cleveland, OH 44113-3108

Mailing address

1730 W 25TH St
Cleveland, OH 44113-3108

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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
I20200228001197 OH Practitioner - Physician Assistant 9830381508 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lutheran HospitalGroup PAC ID 2466358387, 24 clinicians

Practice addresses (Care Compare)

1730 W 25TH St
Cleveland, OH 44113-3108
Phone (440) 826-1822

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Midwest Orthopaedics at Rush, LLC Past Accepting new patients

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": "1267401600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721347200000",
    "number": "1083937338",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1730 W 25TH ST",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441133108"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1730 W 25TH ST",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441133108",
            "telephone_number": "216-385-8051"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUPP",
        "first_name": "HEATHER",
        "middle_name": "LEAH",
        "credential": "PHYSICIAN ASSITANT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-03-01",
        "last_updated": "2024-07-19",
        "certification_date": "2024-07-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OH",
            "license": "50.006277RX",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cleveland, OH

Sources for this page

Verify at the official NPI Registry.