NPIMap

Individual provider Active NPI

Oleksandr Stupnytskyi, M.D.

  • Internal Medicine Physician
  • Lawrence, MA
National Provider Identifier
1598712739
Registry record updated Jan 24, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
233485 Issued in MA
Practice address
25 Marston Street
404A
Lawrence, MA 01841
Phone
(978) 725-5913
Fax
(978) 725-5918
NPI assigned
May 30, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 24, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Hospitalist Physician 208M00000X 36415 KY
Internal Medicine Physician 207R00000X 233485 MA Primary

Addresses

Primary practice location

25 Marston Street
404A
Lawrence, MA 01841

Mailing address

25 Marston St
Apt 203
Lawrence, MA 01841-2357
Phone (978) 725-5913

Other identifiers 9

IdentifierTypeStateIssuer
95867101OtherNETWORK HEALTH
7778264OtherAETNA
1598712739OtherBMC
2140233MedicaidMA
510492088OtherUHC
29164OtherFALLON
AA98601OtherHPHC
J42413OtherBCBS
496927OtherTUFTS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080130000189 MA Practitioner - Internal Medicine 9335194083 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Medical Care of Boston Management CorporationGroup PAC ID 6800787714, 293 clinicians

Practice addresses (Care Compare)

386 Merrimack St
Suite 1C
Methuen, MA 01844-5886
Phone (978) 688-1220

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
233485MAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Medical Care of Boston Management Corporation Internal Medicine CurrentSince Nov 25, 2024 Accepting new patients
Essex Inpatient Physicians, PC Hospitalist PastSince Apr 13, 2013 Accepting new patients
New England Cardiology, L.L.C. Internal Medicine Past Accepting new patients
Kentucky Inpatient Medicine Associates, PLLC Internal Medicine Past Accepting new patients

Locations

1 General St
Lawrence, MA 01841
Phone (978) 946-8103

386 Merrimack St
Ste 1C
Methuen, MA 01844
Phone (978) 688-1220

93 Pond St
Sharon, MA 02067
Phone (781) 784-9212

Interoperability endpoints

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

Organizations & group practices 4

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.

Hospital & facility affiliations 14

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

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1148947200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1579824000000",
    "number": "1598712739",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25 MARSTON ST",
            "address_2": "APT 203",
            "city": "LAWRENCE",
            "state": "MA",
            "postal_code": "018412357",
            "telephone_number": "978-725-5913",
            "fax_number": "978-725-5918"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25 MARSTON STREET",
            "address_2": "404A",
            "city": "LAWRENCE",
            "state": "MA",
            "postal_code": "01841",
            "telephone_number": "978-725-5913",
            "fax_number": "978-725-5918"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STUPNYTSKYI",
        "first_name": "OLEKSANDR",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-30",
        "last_updated": "2020-01-24",
        "certification_date": "2020-01-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "KY",
            "license": "36415",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MA",
            "license": "233485",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NETWORK HEALTH",
            "identifier": "95867101",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "7778264",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BMC",
            "identifier": "1598712739",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2140233",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UHC",
            "identifier": "510492088",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FALLON",
            "identifier": "29164",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HPHC",
            "identifier": "AA98601",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "J42413",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TUFTS",
            "identifier": "496927",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lawrence, MA

Sources for this page

Verify at the official NPI Registry.