Individual provider Active NPI

Elmer Cupino, MD

  • Child & Adolescent Psychiatry Physician
  • Springfield, MA
National Provider Identifier
1376518977
Registry record updated Jul 3, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Child & Adolescent Psychiatry PhysicianTaxonomy code 2084P0804X
License
MD046183L Issued in PA
Practice address
1695 Main St FL 400
Springfield, MA 01103-1063
Phone
(413) 241-3817
Fax
(570) 902-7736
NPI assigned
Feb 17, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 3, 2023

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 72629 MA
Psychiatry Physician 2084P0800X MD046183L PA
Child & Adolescent Psychiatry Physician 2084P0804X 72629 MA
Child & Adolescent Psychiatry Physician 2084P0804X MD046183L PA Primary

Addresses

Primary practice location

1695 Main St FL 400
Springfield, MA 01103-1063

Mailing address

4 Country LN
Douglassville, PA 19518-9627
Phone (570) 617-1268

Other identifiers 2

IdentifierTypeStateIssuer
02873900OtherCAPITAL BLUE CROSS
0012780540003MedicaidPA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA, MA2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20110516000058 PA Practitioner - Psychiatry 2062698707 Reassigns benefits to 2 organizations
Practice locations: Pottstown, PA
I20230816002116 MA Practitioner - Psychiatry 2062698707 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Other, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Redco Group, LLCGroup PAC ID 7911802228, 7 clinicians
Community Services Institute, Inc.Group PAC ID 8224192968, 16 clinicians

Practice addresses (Care Compare)

16 S Centre St
Pottsville, PA 17901-3501
Phone (570) 628-5234

1695 Main St
FL 400
Springfield, MA 01103-1063
Phone 4137395572101

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MD046183LPAMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Redco Group, LLC CurrentSince Jul 1, 1992 Accepting new patients
Community Services Institute, Inc. CurrentSince Jun 13, 2023 Accepting new patients
Pottstown Clinic Company LLC CurrentSince Sep 16, 2019 Accepting new patients
Redco Group, LLC CurrentSince Jul 1, 1992 Accepting new patients
Merakey Pennsylvania Past Accepting new patients
Medical Imaging of Lehigh Valley PC Past Accepting new patients
Windber Hospital, Inc. Past Accepting new patients
Lehigh Valley Hospital - Schuylkill Past Accepting new patients

Locations

1695 Main St
Fl 400
Springfield, MA 01103
Phone (413) 739-5572

305 Second Ave
Collegeville, PA 19426
Phone (484) 961-8220

1600 E High St
Pottstown, PA 19464
Phone (610) 327-7485

730 S Hanover St
Pottstown, PA 19465
Phone (610) 323-6835

Organizations & group practices 8

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.

NPI Registry JSON

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

{
    "created_epoch": "1140134400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1688342400000",
    "number": "1376518977",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4 COUNTRY LN",
            "city": "DOUGLASSVILLE",
            "state": "PA",
            "postal_code": "195189627",
            "telephone_number": "570-617-1268",
            "fax_number": "570-902-7736"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1695 MAIN ST FL 400",
            "city": "SPRINGFIELD",
            "state": "MA",
            "postal_code": "011031063",
            "telephone_number": "413-241-3817",
            "fax_number": "570-902-7736"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CUPINO",
        "first_name": "ELMER",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-02-17",
        "last_updated": "2023-07-03",
        "certification_date": "2023-07-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "MA",
            "license": "72629",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "PA",
            "license": "MD046183L",
            "primary": false
        },
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "MA",
            "license": "72629",
            "primary": false
        },
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "PA",
            "license": "MD046183L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAPITAL BLUE CROSS",
            "identifier": "02873900",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0012780540003",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Springfield, MA

Sources for this page

Verify at the official NPI Registry.