NPIMap

Individual provider Active NPI

Stephen Luke Grupke, MD, MS

  • Neurological Surgery Physician
  • Lubbock, TX
National Provider Identifier
1144454679
Registry record updated Jan 20, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurological Surgery PhysicianTaxonomy code 207T00000X
License
S9137 Issued in TX
Practice address
3601 21St St
Lubbock, TX 79410-1229
Phone
(806) 790-0399
NPI assigned
May 12, 2009
Last updated
Jan 20, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 20, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Neurological Surgery Physician 207T00000X 49206 KY
Neurological Surgery Physician 207T00000X S9137 TX Primary

Addresses

Primary practice location

3601 21St St
Lubbock, TX 79410-1229

Mailing address

2215 Nashville Ave # Ms 106
Lubbock, TX 79410-1105
Phone (806) 725-5844

Other identifiers 3

IdentifierTypeStateIssuer
1K4394OtherTXMEDICARE
40209512MedicaidNM
7100245890MedicaidKY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20201223000252 TX Practitioner - Neurosurgery 4082925193 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Neurosurgery
Education
New York Medical College, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Covenant Medical GroupGroup PAC ID 6901889393, 228 clinicians

Practice addresses (Care Compare)

4408 6TH St
Lubbock, TX 79416-4732
Phone (806) 791-0399

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Spinal fusion82
Laminectomy or laminotomy (partial removal of spine bones)35

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine, Master of Science

State licenses

LicenseStateTypeSpecialty
S9137TXMDNeurological Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Kentucky Medical Services Foundation, Inc CurrentSince Jul 1, 2016 Accepting new patients
Covenant Medical Group Neurological Surgery CurrentSince Dec 26, 2020 Accepting new patients
Covenant Medical Group CurrentSince Dec 26, 2020 Accepting new patients

Locations

2400 Greatstone Pt
Lexington, KY 40504
Phone (859) 257-9800

800 Rose St
#106
Lexington, KY 40536
Phone (859) 323-1334

2215 Nashville Ave
Lubbock, TX 79410
Phone (806) 725-5228

2215 Nashville Ave
#106
Lubbock, TX 79410

3601 21st St
Lubbock, TX 79410
Phone (806) 791-0399

4408 6th St
Lubbock, TX 79416
Phone (806) 791-0399

Interoperability endpoints

  • Direct secure messaging: sgrupke1418168@oc.providencedirect.org

Organizations & group practices 3

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.

Hospital & facility affiliations 6

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1242086400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1642636800000",
    "number": "1144454679",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2215 NASHVILLE AVE # MS 106",
            "city": "LUBBOCK",
            "state": "TX",
            "postal_code": "794101105",
            "telephone_number": "806-725-5844",
            "fax_number": "859-257-8902"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3601 21ST ST",
            "city": "LUBBOCK",
            "state": "TX",
            "postal_code": "794101229",
            "telephone_number": "806-790-0399"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRUPKE",
        "first_name": "STEPHEN",
        "middle_name": "LUKE",
        "name_prefix": "Dr.",
        "credential": "MD, MS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-05-12",
        "last_updated": "2022-01-20",
        "certification_date": "2022-01-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207T00000X",
            "taxonomy_group": "",
            "desc": "Neurological Surgery",
            "state": "KY",
            "license": "49206",
            "primary": false
        },
        {
            "code": "207T00000X",
            "taxonomy_group": "",
            "desc": "Neurological Surgery",
            "state": "TX",
            "license": "S9137",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "1K4394",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "40209512",
            "state": "NM"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100245890",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lubbock, TX

Sources for this page

Verify at the official NPI Registry.