Tara Lynn Kupecki, MS

Primary specialty

SpecialistTaxonomy code 174400000X

Practice address

495 Franklinville Rd.
Laurel, NY 11948

Phone

(631) 315-7173

NPI assigned

Aug 30, 2022

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

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

{
    "created_epoch": "1661817600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1661817600000",
    "number": "1407576432",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1400 STANLEY RD",
            "city": "MATTITUCK",
            "state": "NY",
            "postal_code": "119522780",
            "telephone_number": "631-445-6179"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "495 FRANKLINVILLE RD.",
            "city": "LAUREL",
            "state": "NY",
            "postal_code": "11948",
            "telephone_number": "631-315-7173"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KUPECKI",
        "first_name": "TARA",
        "middle_name": "LYNN",
        "credential": "MS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-08-30",
        "last_updated": "2022-08-30",
        "certification_date": "2022-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NY",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "tkupecki@justkidseclc.org",
            "affiliation": "N",
            "endpointDescription": "work email",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "between providers",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "work phones",
            "address_1": "495 Franklinville Rd.",
            "city": "Laurel",
            "state": "NY",
            "country_code": "US",
            "postal_code": "11948",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Specialist in Laurel, NY
• Providers in Laurel, NY by specialty
• Specialist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 30, 2022; 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.