Individual provider Active NPI

Tanya Alexandra Tupick, D.O.

  • Family Medicine Physician
  • Berlin, NH
National Provider Identifier
1417194374
Registry record updated Sep 15, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
14905 Issued in NH
Practice address
133 Pleasant St
Berlin, NH 03570-2006
Phone
(603) 752-2200
Fax
(603) 752-1836
NPI assigned
Jan 14, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 15, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 14905 NH Primary

Addresses

Primary practice location

133 Pleasant St
Berlin, NH 03570-2006

Mailing address

133 Pleasant St
Berlin, NH 03570-2006
Phone (603) 752-2040

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NH
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 1

Enrollment IDStateProvider typePAC IDDetails
I20100908001073 NH Practitioner - Family Practice 6305961723 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of New England, College of Osteo Medicine, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Coos County Family Health Services IncGroup PAC ID 8628970480, 33 clinicians

Practice addresses (Care Compare)

133 Pleasant St
Berlin, NH 03570-2006
Phone (603) 752-2040

Hospital & facility affiliations

  • Androscoggin Valley Hospital Hospital, Berlin, NH, CCN 301310

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Coos County Family Health Services, Inc Family Medicine CurrentSince Nov 7, 2023 Accepting new patients
Coos County Family Health Services, Inc CurrentSince Nov 7, 2023 Accepting new patients
Coos County Family Health Services, Inc Family Medicine Past Accepting new patients

Locations

59 Page Hill Rd
Berlin, NH 03570
Phone (603) 752-2200

133 Pleasant St
Berlin, NH 03570
Phone (603) 752-2040

167 Main St
#2
Gorham, NH 03581
Phone (603) 466-3500

2 Broadway Ave
Gorham, NH 03581
Phone (603) 466-2741

Organizations & group practices 3

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.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1231891200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1694736000000",
    "number": "1417194374",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "133 PLEASANT ST",
            "city": "BERLIN",
            "state": "NH",
            "postal_code": "035702006",
            "telephone_number": "603-752-2040"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "133 PLEASANT ST",
            "city": "BERLIN",
            "state": "NH",
            "postal_code": "035702006",
            "telephone_number": "603-752-2200",
            "fax_number": "603-752-1836"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TUPICK",
        "first_name": "TANYA",
        "middle_name": "ALEXANDRA",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-01-14",
        "last_updated": "2023-09-15",
        "certification_date": "2023-09-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NH",
            "license": "14905",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Berlin, NH

Sources for this page

Verify at the official NPI Registry.