Individual provider Active NPI

Theresa Lupe, MSN, PMHNP-BC

  • Psychiatric/Mental Health Nurse Practitioner
  • Orlando, FL
National Provider Identifier
1154881027
Registry record updated Mar 25, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
APRN11001232 Issued in FL
Practice address
7000 H C Kelley Rd
Orlando, FL 32831-2521
Phone
(407) 207-7777
NPI assigned
Mar 25, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 25, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X APRN11001232 FL Primary

Addresses

Primary practice location

7000 H C Kelley Rd
Orlando, FL 32831-2521

Mailing address

2230 Michigan St
Melbourne, FL 32904-6131
Phone (321) 271-0503

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20200521000916 FL Practitioner - Nurse Practitioner 9436580727 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Schultz Mental Healthcare Services IncGroup PAC ID 4587071071, 3 clinicians

Practice addresses (Care Compare)

2080 Turtle Mound Rd
Melbourne, FL 32934-8109
Phone (321) 722-7787

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science - Nursing

Practice roles

OrganizationSpecialtyStatusNew patients
Schultz Mental Healthcare Services Inc Psychiatric/Mental Health CurrentSince Oct 1, 2021 Accepting new patients

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1553472000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1553472000000",
    "number": "1154881027",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2230 MICHIGAN ST",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329046131",
            "telephone_number": "321-271-0503"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7000 H C KELLEY RD",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328312521",
            "telephone_number": "407-207-7777"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUPE",
        "first_name": "THERESA",
        "credential": "MSN, PMHNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-03-25",
        "last_updated": "2019-03-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "FL",
            "license": "APRN11001232",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orlando, FL

Sources for this page

Verify at the official NPI Registry.