Individual provider Active NPI

Suzan Mary Lupejkis, LMT

  • Massage Therapist
  • North Tonawanda, NY
National Provider Identifier
1356579189
Registry record updated Jul 1, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
0196251 Issued in NY
Practice address
1089 Kinkead Ave
Suite 203
North Tonawanda, NY 14120-2840
Phone
(716) 474-9977
NPI assigned
Jul 1, 2009
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 1, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Massage Therapist 225700000X 0196251 NY Primary

Addresses

Primary practice location

1089 Kinkead Ave
Suite 203
North Tonawanda, NY 14120-2840

Mailing address

1089 Kinkead Ave
Suite 203
North Tonawanda, NY 14120-2840
Phone (716) 474-9977

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
0196251NYMDMassage Therapist

NPI Registry JSON

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

{
    "created_epoch": "1246406400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1246406400000",
    "number": "1356579189",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1089 KINKEAD AVE",
            "address_2": "SUITE 203",
            "city": "NORTH TONAWANDA",
            "state": "NY",
            "postal_code": "141202840",
            "telephone_number": "716-474-9977"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1089 KINKEAD AVE",
            "address_2": "SUITE 203",
            "city": "NORTH TONAWANDA",
            "state": "NY",
            "postal_code": "141202840",
            "telephone_number": "716-474-9977"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUPEJKIS",
        "first_name": "SUZAN",
        "middle_name": "MARY",
        "credential": "LMT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-07-01",
        "last_updated": "2009-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "NY",
            "license": "0196251",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in North Tonawanda, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.