David M Kuphal, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

1774-023 Issued in WI

Practice address

188 Rockwood LN
Neenah, WI 54956-1983

Phone

(920) 725-4100

Fax

(920) 725-5528

NPI assigned

Jun 12, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 4

Medicare fee-for-service enrollment

Enrolled in WI

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 1999

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Forefront Dermatology SCGroup PAC ID 3779471701, 650 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

97.45 of 100Reported as group

Promoting interoperability

97

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: dave.kuphal@forefrontdermatology.emadirect.md
• Direct secure messaging: david.kuphal.1@17649.direct.athenahealth.com

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.

• Forefront Dermatology, S.C.

  • Dermatology Physician
  • Appleton, WI
  • NPI 1083768253
  Medicare reassignment Care Compare group
• Forefront Dermatology, S.C.

  • Dermatology Physician
  • Neenah, WI
  • NPI 1730347519
  NPD
• Forefront Dermatology, S.C.

  • Dermatology Physician
  • Manitowoc, WI
  • NPI 1578515904
  NPD (past)

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

{
    "created_epoch": "1150070400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1622678400000",
    "number": "1417999269",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "801 YORK ST",
            "city": "MANITOWOC",
            "state": "WI",
            "postal_code": "542204630",
            "telephone_number": "920-683-5278",
            "fax_number": "920-686-9674"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "188 ROCKWOOD LN",
            "city": "NEENAH",
            "state": "WI",
            "postal_code": "549561983",
            "telephone_number": "920-725-4100",
            "fax_number": "920-725-5528"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2351 State Road 44",
            "address_purpose": "LOCATION",
            "city": "Oshkosh",
            "state": "WI",
            "postal_code": "549046333",
            "country_code": "US",
            "telephone_number": "920-651-8855",
            "fax_number": "920-385-0287",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "835 S Main St Ste 1",
            "address_purpose": "LOCATION",
            "city": "Oconto Falls",
            "state": "WI",
            "postal_code": "541541282",
            "country_code": "US",
            "telephone_number": "920-846-4864",
            "fax_number": "920-846-2073",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1400 Scheuring Rd",
            "address_purpose": "LOCATION",
            "city": "DE Pere",
            "state": "WI",
            "postal_code": "541151067",
            "country_code": "US",
            "telephone_number": "920-964-0229",
            "fax_number": "920-964-0248",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KUPHAL",
        "first_name": "DAVID",
        "middle_name": "M",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-12",
        "last_updated": "2021-06-03",
        "certification_date": "2021-06-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WI",
            "license": "1774-023",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "1774-023",
            "state": "WI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "Dave.Kuphal@forefrontdermatology.emadirect.md",
            "affiliation": "N",
            "address_1": "2351 State Road 44",
            "city": "Oshkosh",
            "state": "WI",
            "country_code": "US",
            "postal_code": "549046333",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "Dave.Kuphal@forefrontdermatology.emadirect.md",
            "affiliation": "N",
            "address_1": "835 S Main St Ste 1",
            "city": "Oconto Falls",
            "state": "WI",
            "country_code": "US",
            "postal_code": "541541282",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "Dave.Kuphal@forefrontdermatology.emadirect.md",
            "affiliation": "N",
            "address_1": "188 Rockwood Ln",
            "city": "Neenah",
            "state": "WI",
            "country_code": "US",
            "postal_code": "549561983",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "Dave.Kuphal@forefrontdermatology.emadirect.md",
            "affiliation": "N",
            "address_1": "1400 Scheuring Rd",
            "city": "DE Pere",
            "state": "WI",
            "country_code": "US",
            "postal_code": "541151067",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Evan M Krueger, DO
• Kristin Kryszak
• Andrew Kubisch, PA
• Steven Alan Kueck, DDS
• Elda Kumbier
• Rikka Kushava
• Daniel Kutschera
• Andrea La Barre
• Travis John La Barre, NP
• Petra M Laeven-Sessions, MD

• Physician Assistant in Neenah, WI
• Providers in Neenah, WI by specialty
• Physician Assistant in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.