Susan Lee Krupnick, NP

Key facts

NPI

1295863769

Entity type

Individual (NPI type 1)

Primary specialty

Psychiatric/Mental Health Nurse Practitioner 363LP0808X

License

209891 (MA)

Practice address

55 Fruit St
Ellison 1
Boston, MA 02114-2621

Phone

(617) 643-2307

Fax

(617) 643-2272

NPI assigned

Feb 28, 2007

Sex

Female

Sole proprietor

No

Organizations & group practices 1

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.

• Steward Medical Group, Inc. Specialist · Brighton, MA · NPI 1265745301
  NPD (past)

Medicare participation

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)

Yes

Credentials

Certified Nurse Specialist, Master of Science - Nursing, Nurse Practitioner

State licenses

Practice roles

Specialties & licenses

Addresses

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Jul 8, 2007.

{
    "created_epoch": "1172620800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1295863769",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "119 RICHARDSON CORNER RD",
            "city": "CHARLTON",
            "state": "MA",
            "postal_code": "015071431",
            "telephone_number": "508-248-7108",
            "fax_number": "508-248-7108"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "55 FRUIT ST",
            "address_2": "ELLISON 1",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021142621",
            "telephone_number": "617-643-2307",
            "fax_number": "617-643-2272"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KRUPNICK",
        "first_name": "SUSAN",
        "middle_name": "LEE",
        "name_prefix": "Mrs.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-28",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MA",
            "license": "209891",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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All providers in Boston, MA · Psychiatric/Mental Health Nurse Practitioner in Massachusetts