Individual provider Active NPI

Philip Joseph Lupo, DPM

  • Podiatrist
  • Astoria, NY
National Provider Identifier
1578660288
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
N004412 Issued in NY
Practice address
3217 29TH St
Astoria, NY 11106-3403
Phone
(718) 956-1389
Fax
(718) 726-6446
NPI assigned
Sep 17, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X N004412 NY Primary

Addresses

Primary practice location

3217 29TH St
Astoria, NY 11106-3403

Mailing address

3217 29TH St
Astoria, NY 11106-3403
Phone (718) 956-1389

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120206000369 NY Practitioner - Podiatry 7012174956 Practice locations: Astoria, NY

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
New York College of Podiatric Medicine, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

32 -17
Astoria, NY 11106-3403
Phone (718) 956-1389

3217 29TH St
Astoria, NY 11106-3403

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue1-10
Removal of skin lesions1-10
Removal of nail tissue106

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
N004412NYMDPodiatrist

Networks

  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H5989

NPI Registry JSON

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

{
    "created_epoch": "1158451200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1578660288",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3217 29TH ST",
            "city": "ASTORIA",
            "state": "NY",
            "postal_code": "111063403",
            "telephone_number": "718-956-1389",
            "fax_number": "718-726-6446"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3217 29TH ST",
            "city": "ASTORIA",
            "state": "NY",
            "postal_code": "111063403",
            "telephone_number": "718-956-1389",
            "fax_number": "718-726-6446"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUPO",
        "first_name": "PHILIP",
        "middle_name": "JOSEPH",
        "name_prefix": "Dr.",
        "credential": "DPM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-17",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "NY",
            "license": "N004412",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Astoria, NY

Sources for this page

Verify at the official NPI Registry.