Individual provider Active NPI

Stephen Cupp

  • Emergency Medicine Physician
  • Farmington Hills, MI
National Provider Identifier
1629455993
Registry record updated Feb 22, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
5601007324 Issued in MI
Practice address
31235 Floralview Dr N Apt 205
Farmington Hills, MI 48331-5848
Phone
(248) 231-5476
NPI assigned
May 6, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 22, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 5601007324 MI
Emergency Medicine Physician 207P00000X 5601007324 MI Primary

Addresses

Primary practice location

31235 Floralview Dr N Apt 205
Farmington Hills, MI 48331-5848

Mailing address

31235 Floralview Dr N Apt 205
Farmington Hills, MI 48331-5848
Phone (248) 231-5476

Medicare participation

Medicare enrollment files
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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20151002000317 MI Practitioner - Physician Assistant 3476861956 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
5601007324MIMDEmergency Medicine Physician

Interoperability endpoints

  • Direct secure messaging: scupp@direct.dmc.org

Organizations & group practices 1

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": "1430870400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1645488000000",
    "number": "1629455993",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "31235 FLORALVIEW DR N APT 205",
            "city": "FARMINGTON HILLS",
            "state": "MI",
            "postal_code": "483315848",
            "telephone_number": "248-231-5476"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "31235 FLORALVIEW DR N APT 205",
            "city": "FARMINGTON HILLS",
            "state": "MI",
            "postal_code": "483315848",
            "telephone_number": "248-231-5476"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CUPP",
        "first_name": "STEPHEN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-05-06",
        "last_updated": "2022-02-22",
        "certification_date": "2022-02-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MI",
            "license": "5601007324",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "MI",
            "license": "5601007324",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Farmington Hills, MI

Sources for this page

Verify at the official NPI Registry.