Active NPI
Lyudmila Stepanovna Pupkova, M.D.
- Surgery Physician
- Hazard, KY
National Provider Identifier
1164423109
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgery Physician
- License
- 43967KY
- Practice address
- 210 Blackgold Blvd
Suite 102
Hazard, KY 41701 - Phone
- (606) 487-0885
- NPI assigned
- Aug 1, 2005
- Last updated
- Nov 18, 2011
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgery Physician | 208600000X | 25MA07458500 | NJ | |
| Surgery Physician | 208600000X | 228588 | NY | |
| Surgery Physician | 208600000X | 43967KY | KY | Primary |
| Surgery Physician | 208600000X | MD430562 | PA |
Addresses
Primary practice location
210 Blackgold Blvd
Suite 102
Hazard, KY 41701
Mailing address
210 Blackgold Blvd
Suite 102
Hazard, KY 41701
Phone (606) 487-0885
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 43967KY | KY | MD | Surgery Physician |
| MD430562 | PA | MD | Surgery Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Stony Brook Surgical Associates, University Faculty Practice Corporati | Surgery | Past | Accepting new patients |
| Frederick Health Hospital Inc | Past | Accepting new patients |
Organizations & group practices 2
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.
-
dba Frederick Health Hospital
- General Acute Care Hospital
- Frederick, MD
- NPI 1538165527
-
- Surgery Physician
- Stony Brook, NY
- NPI 1063468536
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1122854400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1321574400000",
"number": "1164423109",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "210 BLACKGOLD BLVD",
"address_2": "SUITE 102",
"city": "HAZARD",
"state": "KY",
"postal_code": "41701",
"telephone_number": "606-487-0885",
"fax_number": "606-487-7332"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "210 BLACKGOLD BLVD",
"address_2": "SUITE 102",
"city": "HAZARD",
"state": "KY",
"postal_code": "41701",
"telephone_number": "606-487-0885"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PUPKOVA",
"first_name": "LYUDMILA",
"middle_name": "STEPANOVNA",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2005-08-01",
"last_updated": "2011-11-18",
"status": "A"
},
"taxonomies": [
{
"code": "208600000X",
"taxonomy_group": "",
"desc": "Surgery",
"state": "NJ",
"license": "25MA07458500",
"primary": false
},
{
"code": "208600000X",
"taxonomy_group": "",
"desc": "Surgery",
"state": "NY",
"license": "228588",
"primary": false
},
{
"code": "208600000X",
"taxonomy_group": "",
"desc": "Surgery",
"state": "KY",
"license": "43967KY",
"primary": true
},
{
"code": "208600000X",
"taxonomy_group": "",
"desc": "Surgery",
"state": "PA",
"license": "MD430562",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Hazard, KY
- Primary Care Centers of Eastern Kentucky, LLC (Primary Care Centers of Eastern Kentucky-Dental)
- Primary Care Centers of Eastern Kentucky, LLC (Primary Care Centers of Eastern Kentucky-Hazard)
- Adam Prokopchak, PSY.D.
- Mary Sarah Prokopchak
- PT Pros, Inc.
- Quantum Healthcare Associates Inc
- Quantum Healthcare Associates Inc
- Hera Fatima Qureshi, D.O.
- Radiology Physician Solutions of Florida, LLC
- Kimberly Raichel, ARNP
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.