Organization Active NPI

Aloupis Dermatology, PA

  • Dermatology Physician
  • Jupiter, FL
National Provider Identifier
1629610415
Registry record updated Aug 6, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
Legal business name
ALOUPIS DERMATOLOGY, PA
Practice address
2141 S Alternate A1A Ste 430
Jupiter, FL 33477-4063
Phone
(561) 313-1230
Fax
(561) 249-3192
NPI assigned
Oct 13, 2019
Last updated
Aug 6, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 6, 2020

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

Authorized official

Name
Kyle Tidwell
Title
Administrator
Phone
(561) 313-1230

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X NU Primary

Addresses

Primary practice location

2141 S Alternate A1A Ste 430
Jupiter, FL 33477-4063

Mailing address

2141 S Alternate A1A Ste 430
Jupiter, FL 33477-4063
Phone (561) 313-1230

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20191203000463 FL Part B Supplier - Clinic/Group Practice 8123451374 Receives reassigned benefits from 1 practitioner
Practice locations: Jupiter, FL

National Provider Directory

National Provider Directory

Locations

5155 Corporate Way
Ste A
Jupiter, FL 33458
Phone (561) 313-1230

Practitioners & affiliated clinicians

Practitioners 10

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1570924800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1596672000000",
    "number": "1629610415",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2141 S ALTERNATE A1A STE 430",
            "city": "JUPITER",
            "state": "FL",
            "postal_code": "334774063",
            "telephone_number": "561-313-1230",
            "fax_number": "561-249-3192"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2141 S ALTERNATE A1A STE 430",
            "city": "JUPITER",
            "state": "FL",
            "postal_code": "334774063",
            "telephone_number": "561-313-1230",
            "fax_number": "561-249-3192"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ALOUPIS DERMATOLOGY, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-10-13",
        "last_updated": "2020-08-06",
        "certification_date": "2020-08-06",
        "status": "A",
        "authorized_official_last_name": "TIDWELL",
        "authorized_official_first_name": "KYLE",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "561-313-1230"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jupiter, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.