Individual provider Active NPI

Erin Jeannine Cupolo, D.P.M.

  • Podiatrist
  • Kennesaw, GA
National Provider Identifier
1134360175
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
POD001163 Issued in GA
Practice address
5205 Stilesboro Rd NW Ste 205
Kennesaw, GA 30152-7765
Phone
(678) 310-0540
Fax
(678) 310-0538
NPI assigned
Mar 22, 2009
Last updated
Jul 21, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X POD001163 GA Primary

Addresses

Primary practice location

5205 Stilesboro Rd NW Ste 205
Kennesaw, GA 30152-7765

Mailing address

5205 Stilesboro Rd NW
Suite 205
Kennesaw, GA 30152-7744
Phone (678) 310-0540

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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 1

Enrollment IDStateProvider typePAC IDDetails
I20110916000061 GA Practitioner - Podiatry 0749451003 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
Ohio State University College of Medicine, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Georgia Podiatry, IncGroup PAC ID 7810165354, 3 clinicians

Practice addresses (Care Compare)

5205 Stilesboro Rd NW
Suite 205
Kennesaw, GA 30152-7765
Phone (678) 310-0540

Merit-based Incentive Payment System (MIPS)

Final score
93.93 of 100Reported as apm
Quality
82.14
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue1-10
Removal of nail tissue3540
Removal or shaving of skin growth41

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
POD001163GAMDPodiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
Georgia Podiatry, Inc Podiatrist CurrentSince May 20, 2013 Accepting new patients

Locations

5150 Stilesboro Rd NW
Ste 620
Kennesaw, GA 30152
Phone (678) 310-0540

5205 Stilesboro Rd NW
Ste 205
Kennesaw, GA 30152
Phone (678) 310-0540

Organizations & group practices 1

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": "1237680000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1134360175",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5205 STILESBORO RD NW",
            "address_2": "SUITE 205",
            "city": "KENNESAW",
            "state": "GA",
            "postal_code": "301527744",
            "telephone_number": "678-310-0540",
            "fax_number": "678-310-0538"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5205 STILESBORO RD NW STE 205",
            "city": "KENNESAW",
            "state": "GA",
            "postal_code": "301527765",
            "telephone_number": "678-310-0540",
            "fax_number": "678-310-0538"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CUPOLO",
        "first_name": "ERIN",
        "middle_name": "JEANNINE",
        "credential": "D.P.M.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-03-22",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "GA",
            "license": "POD001163",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kennesaw, GA

Sources for this page

Verify at the official NPI Registry.