Individual provider Active NPI

Chereve Hupkowicz

  • Nurse Practitioner
  • Orchard Park, NY
National Provider Identifier
1275172934
Registry record updated Jun 6, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
344985 Issued in NY
Practice address
5800 Big Tree Rd
Orchard Park, NY 14127-4116
Phone
(716) 662-7337
NPI assigned
Dec 30, 2019
Last updated
Jun 6, 2022By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 6, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 344985 NY Primary

Addresses

Primary practice location

5800 Big Tree Rd
Orchard Park, NY 14127-4116

Mailing address

2989 Pleasant Ave
Hamburg, NY 14075-3625
Phone (716) 680-3686

Other practice location 1

2989 Pleasant Ave
Hamburg, NY 14075-3625
Phone (716) 680-3686

Other identifiers 1

IdentifierTypeStateIssuer
344985OtherNYNYS LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, MI2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20200204002320 NY Practitioner - Nurse Practitioner 2860828126 Reassigns benefits to 1 organization
I20230425002807 MI Practitioner - Nurse Practitioner 2860828126 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
344985NYMDLicensed Practical Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Molina Healthcare of New York, Inc. Nurse Practitioner CurrentSince Apr 11, 2022 Accepting new patients
Molina Care Connections, LLC. Nurse Practitioner CurrentSince Mar 17, 2023 Accepting new patients
Western New York Pediatric Associates, LLP PastSince Jun 12, 2022 Accepting new patients

Locations

200 Oceangate
Ste 100
Long Beach, CA 90802
Phone (562) 435-3666

880 W Long Lake Rd
Troy, MI 48098
Phone (248) 227-6316

5232 Witz Dr
North Syracuse, NY 13212
Phone (315) 632-5960

Interoperability endpoints

  • Direct secure messaging: cferry13219@direct-prd.molinahealthcare.com

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.

NPI Registry JSON

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

{
    "created_epoch": "1577664000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1654473600000",
    "number": "1275172934",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2989 PLEASANT AVE",
            "city": "HAMBURG",
            "state": "NY",
            "postal_code": "140753625",
            "telephone_number": "716-680-3686"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5800 BIG TREE RD",
            "city": "ORCHARD PARK",
            "state": "NY",
            "postal_code": "141274116",
            "telephone_number": "716-662-7337"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2989 Pleasant Ave",
            "address_purpose": "LOCATION",
            "city": "Hamburg",
            "state": "NY",
            "postal_code": "140753625",
            "country_code": "US",
            "telephone_number": "716-680-3686",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HUPKOWICZ",
        "first_name": "CHEREVE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-12-30",
        "last_updated": "2022-06-06",
        "certification_date": "2020-09-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NY",
            "license": "344985",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NYS LICENSE",
            "identifier": "344985",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Orchard Park, NY

Sources for this page

Verify at the official NPI Registry.