Individual provider Active NPI

Debra M Halupa, NP

  • Family Nurse Practitioner
  • Pine Grove, PA
National Provider Identifier
1104810647
Registry record updated Feb 26, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
VP006085B Issued in PA
Practice address
121 N Tulpehocken St
Pine Grove, PA 17963-1217
Phone
(570) 345-2345
Fax
(570) 345-2350
NPI assigned
Sep 9, 2005
Last updated
Feb 26, 2017By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 26, 2017

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X VP006085-B PA
Family Nurse Practitioner 363LF0000X VP006085B PA Primary

Addresses

Primary practice location

121 N Tulpehocken St
Pine Grove, PA 17963-1217

Mailing address

PO Box 783311
Philadelphia, PA 19178-3311
Phone (484) 884-4500

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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
I20041005000874 PA Practitioner - Nurse Practitioner 6204895329 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
83.64 of 100Reported as group
Quality
76.75
Promoting interoperability
87
Improvement activities
40
Cost
74.84

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
VP006085-BPAMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Schuylkill Health System Medical Group, Inc. CurrentSince Sep 15, 2014 Accepting new patients
Schuylkill Health System Medical Group, Inc. Family CurrentSince Sep 15, 2014 Accepting new patients
Schuylkill Medical Center-East Norwegian Street RMC Past Accepting new patients
Schuylkill Medical Center - East Norwegian Street Past Accepting new patients

Locations

121 N Tulpehocken St
Pine Grove, PA 17963
Phone (570) 345-2345

205 E Laurel Blvd
Pottsville, PA 17901
Phone (570) 622-1887

700 Schuylkill Manor Rd
Ste 3
Pottsville, PA 17901
Phone (570) 621-4440

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1126224000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1488067200000",
    "number": "1104810647",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 783311",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191783311",
            "telephone_number": "484-884-4500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "121 N TULPEHOCKEN ST",
            "city": "PINE GROVE",
            "state": "PA",
            "postal_code": "179631217",
            "telephone_number": "570-345-2345",
            "fax_number": "570-345-2350"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HALUPA",
        "first_name": "DEBRA",
        "middle_name": "M",
        "name_prefix": "Mr.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-09-09",
        "last_updated": "2017-02-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "PA",
            "license": "VP006085-B",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "PA",
            "license": "VP006085B",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pine Grove, PA

Sources for this page

Verify at the official NPI Registry.