Active NPI
Stephen Kupersmith, MD
- Obstetrics & Gynecology Physician
- Sellersville, PA
National Provider Identifier
1093713380
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Obstetrics & Gynecology Physician
- License
- MD020807E
- Practice address
- 670 Lawn Ave
Suite 4
Sellersville, PA 18960-1571 - Phone
- (215) 257-0414
- Fax
- (215) 257-1740
- NPI assigned
- Jul 11, 2005
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Obstetrics & Gynecology Physician | 207V00000X | MD020807E | PA | Primary |
Addresses
Primary practice location
670 Lawn Ave
Suite 4
Sellersville, PA 18960-1571
Mailing address
670 Lawn Ave
Suite 4
Sellersville, PA 18960-1571
Phone (215) 257-0414
Other identifiers 5
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0021882000 | Other | PA | INDEPENDENCE BLUE CROSS |
| 112877 | Other | PA | AETNA |
| 100769 | Other | PA | OTHER BC |
| 1033585 | Other | PA | OTHER HMO (MERCY) |
| 0009218500001 | Medicaid | PA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1121040000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183939200000",
"number": "1093713380",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "670 LAWN AVE",
"address_2": "SUITE 4",
"city": "SELLERSVILLE",
"state": "PA",
"postal_code": "189601571",
"telephone_number": "215-257-0414",
"fax_number": "215-257-1740"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "670 LAWN AVE",
"address_2": "SUITE 4",
"city": "SELLERSVILLE",
"state": "PA",
"postal_code": "189601571",
"telephone_number": "215-257-0414",
"fax_number": "215-257-1740"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KUPERSMITH",
"first_name": "STEPHEN",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-07-11",
"last_updated": "2007-07-09",
"status": "A"
},
"taxonomies": [
{
"code": "207V00000X",
"taxonomy_group": "",
"desc": "Obstetrics & Gynecology",
"state": "PA",
"license": "MD020807E",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "INDEPENDENCE BLUE CROSS",
"identifier": "0021882000",
"state": "PA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA",
"identifier": "112877",
"state": "PA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "OTHER BC",
"identifier": "100769",
"state": "PA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "OTHER HMO (MERCY)",
"identifier": "1033585",
"state": "PA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0009218500001",
"state": "PA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Sellersville, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.