Individual provider Active NPI

Debra Lupo, DC

  • Chiropractor
  • Middle Island, NY
National Provider Identifier
1184700817
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
X005369 Issued in NY
Practice address
225 Middle Country Rd
Middle Island, NY 11953-2553
Phone
(631) 924-5890
Fax
(631) 924-3221
NPI assigned
Oct 27, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X X005369 NY Primary

Addresses

Primary practice location

225 Middle Country Rd
Middle Island, NY 11953-2553

Mailing address

225 Middle Country Rd
Middle Island, NY 11953-2553
Phone (631) 924-5890

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090506000387 NY Practitioner - Chiropractic 2567510217 Practice locations: Middle Island, NY

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
National College of Chiropractic, 1987
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

59 Maple Country Rd
Middle Island, NY 11953-2502
Phone (631) 924-3220

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
X005369NYMDChiropractor

NPI Registry JSON

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

{
    "created_epoch": "1161907200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1184700817",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "225 MIDDLE COUNTRY RD",
            "city": "MIDDLE ISLAND",
            "state": "NY",
            "postal_code": "119532553",
            "telephone_number": "631-924-5890",
            "fax_number": "631-924-3221"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "225 MIDDLE COUNTRY RD",
            "city": "MIDDLE ISLAND",
            "state": "NY",
            "postal_code": "119532553",
            "telephone_number": "631-924-5890",
            "fax_number": "631-924-3221"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUPO",
        "first_name": "DEBRA",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-27",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NY",
            "license": "X005369",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Middle Island, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.