Individual provider Active NPI

Noah Vincenzo Lupica, MD

  • Pediatrics Physician
  • Greenwich, CT
National Provider Identifier
1417538109
Registry record updated Jun 25, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
CMD20062 Issued in RI
Practice address
644 W Putnam Ave # 203
Greenwich, CT 06830-6088
Phone
(203) 661-6430
Fax
(203) 661-2597
NPI assigned
Apr 15, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 25, 2026

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X CMD20062 RI Primary
Pediatrics Physician 208000000X 343022 NY
Pediatrics Physician 208000000X 83992 CT

Addresses

Primary practice location

644 W Putnam Ave # 203
Greenwich, CT 06830-6088

Mailing address

644 W Putnam Ave # 203
Greenwich, CT 06830-6088
Phone (203) 661-6430

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in RI
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
I20240913000663 RI Practitioner - Pediatric Medicine 3274942602 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
CMD20062RIMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Thundermist Health Center CurrentSince Sep 9, 2024 Accepting new patients
Thundermist Health Center CurrentSince Sep 9, 2024 Accepting new patients
Thundermist Health Center Past Accepting new patients

Locations

360 Kingstown Rd
Unit 101
Narragansett, RI 02882
Phone (401) 783-3334

186 Providence St
West Warwick, RI 02893
Phone (401) 615-2800

450 Clinton St
Woonsocket, RI 02895

25 John a Cummings Way
Ste 302
Woonsocket, RI 02895

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/DCBEAA

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.

NPI Registry JSON

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

{
    "created_epoch": "1618444800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1782345600000",
    "number": "1417538109",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "644 W PUTNAM AVE # 203",
            "city": "GREENWICH",
            "state": "CT",
            "postal_code": "068306088",
            "telephone_number": "203-661-6430",
            "fax_number": "203-661-2597"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "644 W PUTNAM AVE # 203",
            "city": "GREENWICH",
            "state": "CT",
            "postal_code": "068306088",
            "telephone_number": "203-661-6430",
            "fax_number": "203-661-2597"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUPICA",
        "first_name": "NOAH",
        "middle_name": "VINCENZO",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-04-15",
        "last_updated": "2026-06-25",
        "certification_date": "2026-06-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "RI",
            "license": "CMD20062",
            "primary": true
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NY",
            "license": "343022",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CT",
            "license": "83992",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Greenwich, CT

Sources for this page

Verify at the official NPI Registry.