Individual provider Active NPI

Michael P Krupa, ED.D.

  • Psychologist
  • Winchester, MA
National Provider Identifier
1497923908
Registry record updated Feb 19, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
3950 Issued in MA
Practice address
48 Mount Vernon St
Winchester, MA 01890-2722
Phone
(781) 979-0700
Fax
(781) 979-9071
NPI assigned
Feb 19, 2008
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 19, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 3950 MA Primary

Addresses

Primary practice location

48 Mount Vernon St
Winchester, MA 01890-2722

Mailing address

48 Mount Vernon St
Winchester, MA 01890-2722
Phone (781) 979-0700

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3950MAMDPhysical Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Holyoke Capital JV, LLC CurrentSince Jan 1, 2022 Accepting new patients
Devens Treatment & Recovery Center, LLC Current Accepting new patients
Devens Treatment & Recovery Center, LLC Current Accepting new patients

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": "1203379200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1203379200000",
    "number": "1497923908",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "48 MOUNT VERNON ST",
            "city": "WINCHESTER",
            "state": "MA",
            "postal_code": "018902722",
            "telephone_number": "781-979-0700",
            "fax_number": "781-979-9071"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "48 MOUNT VERNON ST",
            "city": "WINCHESTER",
            "state": "MA",
            "postal_code": "018902722",
            "telephone_number": "781-979-0700",
            "fax_number": "781-979-9071"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KRUPA",
        "first_name": "MICHAEL",
        "middle_name": "P",
        "credential": "ED.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-02-19",
        "last_updated": "2008-02-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "MA",
            "license": "3950",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Winchester, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 2008; 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.