Joshua Tzvi Schupp-Star, PA-C

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

055.0031537 Issued in VT

Practice address

125 Saint Paul St Ste 103
Burlington, VT 05401-8686

Phone

(802) 216-0727

Fax

(802) 633-0956

NPI assigned

Mar 10, 2021

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• Green Mountain Behavioral Medicine LLC

  • Psychiatry Physician
  • Burlington, VT
  • NPI 1992481568
  NPD Authorized official
• Couch Psychiatry

  • Psychiatry Physician
  • Beverly Hills, CA
  • NPI 1376258921
  NPD

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

{
    "created_epoch": "1615334400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1680048000000",
    "number": "1376128447",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "125 SAINT PAUL ST STE 103",
            "city": "BURLINGTON",
            "state": "VT",
            "postal_code": "054018462",
            "telephone_number": "802-216-0727",
            "fax_number": "802-633-0956"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "125 SAINT PAUL ST STE 103",
            "city": "BURLINGTON",
            "state": "VT",
            "postal_code": "054018686",
            "telephone_number": "802-216-0727",
            "fax_number": "802-633-0956"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHUPP-STAR",
        "first_name": "JOSHUA",
        "middle_name": "TZVI",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-03-10",
        "last_updated": "2023-03-29",
        "certification_date": "2023-03-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "VT",
            "license": "055.0031537",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "VT",
            "license": "055.0031537",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• William Schubart, LICSW
• Kristine Schullo, MD
• Claire Schultz, M.D.
• Heidi Kristen Schumacher, MD
• Karen A Schumacher, LICSW
• Erica Schwab
• Jessica Schwartz, LICSW
• Zachary Schwartz, N.P.
• Patrick Victor Schwartzhoff, MD
• Edward Sylvan Schwartzreich, M.D.

• All providers in Burlington, VT
• Psychiatric/Mental Health Nurse Practitioner in Vermont

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 29, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.