Individual provider Active NPI

Maria Dawn Cupo, AG-ACNP-BC

  • Acute Care Nurse Practitioner
  • Hazlet, NJ
National Provider Identifier
1609590918
Registry record updated Jan 11, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
432504 Issued in NY
Practice address
34 Buttonwood PL
Hazlet, NJ 07730-2109
Phone
(347) 596-7114
NPI assigned
Sep 29, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 11, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered NurseGroup: 193400000X SINGLE SPECIALTY GROUP 163W00000X 676148 NY
Acute Care Nurse Practitioner 363LA2100X 432504 NY Primary

Addresses

Primary practice location

34 Buttonwood PL
Hazlet, NJ 07730-2109

Mailing address

34 Buttonwood PL
Hazlet, NJ 07730-2109
Phone (347) 596-7114

Other practice location 1

475 Seaview Ave
Staten Island, NY 10305-3436
Phone (718) 226-9000

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address mvasta@northwell.edu Direct STATEN ISLAND UNIVERSITY HOSPITAL
Other URL vitalyte.me@gmail.com Direct

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: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230404000498 NY Practitioner - Nurse Practitioner 3779958822 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
North Shore-Lij Medical PCGroup PAC ID 3375701568, 6,374 clinicians

Practice addresses (Care Compare)

475 Seaview Ave
Staten Island, NY 10305-3436
Phone (212) 434-6980

Hospital & facility affiliations

  • Staten Island University Hospital Hospital, Staten Island, NY, CCN 330160

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
676148NYMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
North Shore - Lij Medical PC CurrentSince Jan 1, 2023 Accepting new patients
North Shore-Lij Medical PC Single Specialty CurrentSince Jan 1, 2023 Accepting new patients

Locations

300 Community Dr
Plandome, NY 11030

475 Seaview Ave
Staten Island, NY 10305
Phone (718) 226-8855

972 Brush Hollow Rd
Westbury, NY 11590

Networks

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

Interoperability endpoints

  • Direct secure messaging: mcupo27435@northwell.direct-ci.com

Organizations & group practices 2

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 1

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

NPI Registry JSON

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

{
    "created_epoch": "1664409600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1673395200000",
    "number": "1609590918",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "34 BUTTONWOOD PL",
            "city": "HAZLET",
            "state": "NJ",
            "postal_code": "077302109",
            "telephone_number": "347-596-7114"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "34 BUTTONWOOD PL",
            "city": "HAZLET",
            "state": "NJ",
            "postal_code": "077302109",
            "telephone_number": "347-596-7114"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "475 Seaview Ave",
            "address_purpose": "LOCATION",
            "city": "Staten Island",
            "state": "NY",
            "postal_code": "103053436",
            "country_code": "US",
            "telephone_number": "718-226-9000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CUPO",
        "first_name": "MARIA",
        "middle_name": "DAWN",
        "name_prefix": "Mrs.",
        "credential": "AG-ACNP-BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-09-29",
        "last_updated": "2023-01-11",
        "certification_date": "2023-01-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "676148",
            "primary": false
        },
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "NY",
            "license": "432504",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mvasta@northwell.edu",
            "affiliation": "Y",
            "endpointDescription": "email",
            "affiliationName": "STATEN ISLAND UNIVERSITY HOSPITAL",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "email",
            "address_1": "475 Seaview Ave",
            "city": "Staten Island",
            "state": "NY",
            "country_code": "US",
            "postal_code": "103053436",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "vitalyte.me@gmail.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "34 Buttonwood Pl",
            "city": "Hazlet",
            "state": "NJ",
            "country_code": "US",
            "postal_code": "077302109",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Hazlet, NJ

Sources for this page

Verify at the official NPI Registry.