Individual provider Active NPI

Jeffrey C Lupica, DPM

  • Podiatrist
  • Mentor, OH
National Provider Identifier
1164749859
Registry record updated Jun 15, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
36003664 Issued in OH
Practice address
9500 Mentor Ave
Suite 210
Mentor, OH 44060-8713
Phone
(440) 352-1711
NPI assigned
Apr 21, 2010
Last updated
Jun 15, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 15, 2021

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X 36003664 OH Primary
Foot & Ankle Surgery Podiatrist 213ES0103X 36003664 OH
Foot Surgery Podiatrist 213ES0131X 36003664 OH

Addresses

Primary practice location

9500 Mentor Ave
Suite 210
Mentor, OH 44060-8713

Mailing address

9500 Mentor Ave
Suite 210
Mentor, OH 44060-8713
Phone (440) 352-1711

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address Jeffrey.lupica@loa.eclinicaldirectplus.com Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130615000184 OH Practitioner - Podiatry 6901045327 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
Kent State University College of Podiatric Medicine, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

36060 Euclid Ave
Suite 104
Willoughby, OH 44094-4661
Phone (440) 942-1050

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Lower limb (leg) arthroscopy (minimally invasive joint repair)1-10
Removal of tissue51
Removal of nail tissue61

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
36003664OHMDPodiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
Lake Orthopaedic Associates, Inc. CurrentSince Jul 22, 2013 Accepting new patients
Lake Orthopaedic Associates, Inc. CurrentSince Jul 22, 2013 Accepting new patients
Lake Orthopaedic Associates, Inc. Current Accepting new patients

Locations

9500 Mentor Ave
Ste 210
Mentor, OH 44060
Phone (440) 352-0934

36060 Euclid Ave
Ste 104
Willoughby, OH 44094
Phone (440) 942-1050

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/FBFBCA
  • Direct secure messaging: jeffrey.lupica@loa.eclinicaldirectplus.com
  • Direct secure messaging: jlupica219284@ehrdirect.uhhospitals.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 1

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": "1271808000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623715200000",
    "number": "1164749859",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9500 MENTOR AVE",
            "address_2": "SUITE 210",
            "city": "MENTOR",
            "state": "OH",
            "postal_code": "440608713",
            "telephone_number": "440-352-1711"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9500 MENTOR AVE",
            "address_2": "SUITE 210",
            "city": "MENTOR",
            "state": "OH",
            "postal_code": "440608713",
            "telephone_number": "440-352-1711"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUPICA",
        "first_name": "JEFFREY",
        "middle_name": "C",
        "name_prefix": "Dr.",
        "credential": "DPM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-04-21",
        "last_updated": "2021-06-15",
        "certification_date": "2021-06-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "OH",
            "license": "36003664",
            "primary": true
        },
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "OH",
            "license": "36003664",
            "primary": false
        },
        {
            "code": "213ES0131X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot Surgery",
            "state": "OH",
            "license": "36003664",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "Jeffrey.lupica@loa.eclinicaldirectplus.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCDA",
            "address_1": "9500 Mentor Ave",
            "address_2": "Suite 210",
            "city": "Mentor",
            "state": "OH",
            "country_code": "US",
            "postal_code": "440608713",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Mentor, OH

Sources for this page

Verify at the official NPI Registry.