Justin Michael Schupbach, MD

Primary specialty

Sports Medicine (Orthopaedic Surgery) PhysicianTaxonomy code 207XX0005X

License

4301501869 Issued in MI

Practice address

24 Frank Lloyd Wright Dr Lbby a
Ann Arbor, MI 48105-9484

Phone

(734) 930-7400

NPI assigned

Aug 3, 2020

Last updated

Aug 3, 2020By the provider in NPPES

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

Medicare fee-for-service enrollment

Enrolled in MI

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

Specialty

Orthopedic Surgery

Education

Wayne State University School of Medicine, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Jawad a Shah MD PCGroup PAC ID 5799779633, 89 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Southeast Michigan Surgical Hospital LLC Hospital, Warren, MI, CCN 230264
• Ascension Genesys Hospital Hospital, Grand Blanc, MI, CCN 230197
• McLaren Flint Hospital, Flint, MI, CCN 230141

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jschupbach296583@direct.hfhs.org

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.

• Jawad a Shah, MD PC

  • Specialist
  • Flint, MI
  • NPI 1942402391
  Medicare reassignment Care Compare group NPD
• Jawad a Shah MD PC

  • Durable Medical Equipment & Medical Supplies
  • Dearborn, MI
  • NPI 1114667763
  NPD

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

• Henry Ford Health Genesys Hospital

  • General Acute Care Hospital
  • Grand Blanc, MI
  • NPI 1407877723
  Care Compare affiliation
• McLaren Flint

  • General Acute Care Hospital
  • Flint, MI
  • NPI 1902894512
  Care Compare affiliation
• Southeast Michigan Surgical Hospital, LLC

  dba Insight Surgical Hospital

  • General Acute Care Hospital
  • Warren, MI
  • NPI 1962402354
  Care Compare affiliation

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

{
    "created_epoch": "1596412800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1596412800000",
    "number": "1457961716",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "215 W LIBERTY ST",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481041322",
            "telephone_number": "734-436-9661"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24 FRANK LLOYD WRIGHT DR LBBY A",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481059484",
            "telephone_number": "734-930-7400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHUPBACH",
        "first_name": "JUSTIN",
        "middle_name": "MICHAEL",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-08-03",
        "last_updated": "2020-08-03",
        "certification_date": "2020-08-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207XX0005X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Sports Medicine",
            "state": "MI",
            "license": "4301501869",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• William Schultz, MD
• Jenni Lynn Schulz, CNM
• Kurt Robert Schumacher, M.D.
• Robert E Schumacher, MD
• Allison Schumaker
• Timothy Schurz, MD
• Matt Schuster, BSW
• Melisa Marie Schuster, MSW
• Anne E. Schutter, MD
• Kristen Hope Schuyten

• Sports Medicine (Orthopaedic Surgery) Physician in Ann Arbor, MI
• Providers in Ann Arbor, MI by specialty
• Sports Medicine (Orthopaedic Surgery) Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 3, 2020; 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.