Individual provider Active NPI

Virginia Kitch Lupo, M.S.

  • Audiologist
  • Los Angeles, CA
National Provider Identifier
1407028913
Registry record updated May 23, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
AudiologistTaxonomy code 231H00000X
License
AU2896 Issued in CA
Practice address
200 UCLA Medical PLZ # 540
Los Angeles, CA 90095-8344
Phone
(310) 825-5721
NPI assigned
Mar 25, 2008
Last updated
May 23, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 23, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Audiologist 231H00000X 345 CO
Audiologist 231H00000X AU2896 CA Primary

Addresses

Primary practice location

200 UCLA Medical PLZ # 540
Los Angeles, CA 90095-8344

Mailing address

200 UCLA Medical PLZ # 540
Los Angeles, CA 90095-8344
Phone (310) 825-5721

Other practice location 1

2045 N Franklin St
Denver, CO 80205-5437
Phone (303) 338-4545

Other identifiers 1

IdentifierTypeStateIssuer
59186348MedicaidCO

Electronic endpoints 1

TypeEndpointUseAffiliation
SOAP URL https://careepiceast.kp.org:14430/Interconnect-prodcom/wcf/epic.community.hie/xcpdrespondinggateways Health Information Exchange (HIE)

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190130002137 CO Practitioner - Qualified Audiologist 5890032759 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
345COMDPodiatrist
AU2896CAMDAudiologist

Practice roles

OrganizationSpecialtyStatusNew patients
Colorado Permanente Medical Group, P.C. CurrentSince Jan 8, 2020 Accepting new patients

Locations

10350 E Dakota Ave
Denver, CO 80247
Phone (303) 636-3350

2045 N Franklin St
Denver, CO 80205
Phone (303) 764-4666

Organizations & group practices 2

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": "1206403200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1621728000000",
    "number": "1407028913",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 UCLA MEDICAL PLZ # 540",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900958344",
            "telephone_number": "310-825-5721"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 UCLA MEDICAL PLZ # 540",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900958344",
            "telephone_number": "310-825-5721"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2045 N Franklin St",
            "address_purpose": "LOCATION",
            "city": "Denver",
            "state": "CO",
            "postal_code": "802055437",
            "country_code": "US",
            "telephone_number": "303-338-4545",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LUPO",
        "first_name": "VIRGINIA",
        "middle_name": "KITCH",
        "credential": "M.S.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-03-25",
        "last_updated": "2021-05-23",
        "certification_date": "2021-05-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "CO",
            "license": "345",
            "primary": false
        },
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "CA",
            "license": "AU2896",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "59186348",
            "state": "CO"
        }
    ],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepiceast.kp.org:14430/Interconnect-prodcom/wcf/epic.community.hie/xcpdrespondinggateways",
            "affiliation": "N",
            "endpointDescription": "CAREQUALITY",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "2045 N Franklin St",
            "city": "Denver",
            "state": "CO",
            "country_code": "US",
            "postal_code": "802055437",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 23, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.