Sarah Lupa, MS, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

085004722 Issued in IL

Practice address

1050 Chicago Ave
Oak Park, IL 60302-1835

Phone

(708) 383-6366

Fax

(708) 383-6449

NPI assigned

Nov 8, 2013

Last updated

Feb 23, 2023By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Other names 1

• Sarah Grosse Former name

Medicare fee-for-service enrollment

Enrolled in IL

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

Specialty

Physician Assistant

Education

Other, 2013

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

West Suburban Dermatology and Cosmetic SurgeryGroup PAC ID 6204890460, 5 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science, Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: slupa1@clearskin.emadirect.md

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.

• West Suburban Dermatology & Cosmetic Surgery

  dba Clear Skin Dermatology

  • Dermatology Physician
  • St Charles, IL
  • NPI 1477617207
  Medicare reassignment Care Compare group
• Affiliates in Diseases & Surgery of the Skin, S.C.

  • Medical Specialty Clinic/Center
  • Oak Park, IL
  • NPI 1558579243

  Single Specialty

  NPD

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

{
    "created_epoch": "1383868800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1677110400000",
    "number": "1144659392",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1050 CHICAGO AVE",
            "city": "OAK PARK",
            "state": "IL",
            "postal_code": "603021835",
            "telephone_number": "708-383-6366",
            "fax_number": "708-383-6449"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1050 CHICAGO AVE",
            "city": "OAK PARK",
            "state": "IL",
            "postal_code": "603021835",
            "telephone_number": "708-383-6366",
            "fax_number": "708-383-6449"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUPA",
        "first_name": "SARAH",
        "name_prefix": "Miss",
        "credential": "MS, PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-11-08",
        "last_updated": "2023-02-23",
        "certification_date": "2023-02-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "IL",
            "license": "85004722",
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "IL",
            "license": "385.003397",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physician Assistant, Medical",
            "state": "IL",
            "license": "085004722",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SARAH",
            "last_name": "GROSSE",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Mary Ludvigsen, N.P.
• Josephine Luis
• Tim T. Luk, D.O.
• John Danford Lund III, M.D.
• Paul S Luning, MD
• Roger A Lupei, PH.D.
• Sarah Lusche, LSW
• Luxottica of America Inc (For Eyes (Cm256))
• Josephine M Lyles Lynn, LCSW
• Gerald E Lynch, MD

• Medical Physician Assistant in Oak Park, IL
• Providers in Oak Park, IL by specialty
• Medical Physician Assistant in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 23, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.