Individual provider Active NPI

Supapan Nualpring, M.D.

  • Internal Medicine Physician
  • Danvers, MA
National Provider Identifier
1164716205
Registry record updated May 16, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
257578 Issued in MA
Practice address
194R North St
Danvers, MA 01923-1242
Phone
(978) 354-4009
NPI assigned
Jun 7, 2011
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 16, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X 248583 MA
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X 257578 MA Primary

Addresses

Primary practice location

194R North St
Danvers, MA 01923-1242

Mailing address

194R North St
Danvers, MA 01923-1242

Other practice location 1

81 Highland Ave
Salem, MA 01970-2714
Phone (978) 741-1200

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140826000064 MA Practitioner - HospitalistPractitioner - Internal Medicine 8820236854 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
HospitalistAlso: Internal Medicine
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

1 Hutchinson Dr
Danvers, MA 01923-3748
Phone (978) 739-6950

194 R N St
Danvers, MA 01923-1242
Phone (978) 646-2100

Hospital & facility affiliations

  • Mass General Brigham Home Care, Inc Home health agency, Newton, MA, CCN 227207
  • North Shore Medical Center - Hospital, Salem, MA, CCN 220035
  • Massachusetts General Hospital Hospital, Boston, MA, CCN 220071
  • Spaulding Rehabilitation Hospital Inpatient rehabilitation facility, Charlestown, MA, CCN 223034

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
North Shore Medical Center, Inc. Single Specialty Current Accepting new patients
Mass General Brigham Medical Group Northern Massachusetts Inc Single Specialty CurrentSince Aug 21, 2014 Accepting new patients

Locations

1 Hutchinson Dr
Danvers, MA 01923
Phone (978) 739-6950

194 North St
#R
Danvers, MA 01923
Phone (978) 561-6363

81 Highland Ave
Salem, MA 01970
Phone (978) 354-4009

Interoperability endpoints

  • Direct secure messaging: nualpring.supapan.nsmc@direct.partners.masshiway.net

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 and National Provider Directory roles.

Hospital & facility affiliations 4

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": "1307404800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1747353600000",
    "number": "1164716205",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "194R NORTH ST",
            "city": "DANVERS",
            "state": "MA",
            "postal_code": "019231242"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "194R NORTH ST",
            "city": "DANVERS",
            "state": "MA",
            "postal_code": "019231242",
            "telephone_number": "978-354-4009"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "81 Highland Ave",
            "address_purpose": "LOCATION",
            "city": "Salem",
            "state": "MA",
            "postal_code": "019702714",
            "country_code": "US",
            "telephone_number": "978-741-1200",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NUALPRING",
        "first_name": "SUPAPAN",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-06-07",
        "last_updated": "2025-05-16",
        "certification_date": "2025-05-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "MA",
            "license": "248583",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "MA",
            "license": "257578",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Danvers, MA

Sources for this page

Verify at the official NPI Registry.