NPIMap

Individual provider Active NPI

Alfred Schupp III, MD

  • Physical Medicine & Rehabilitation Physician
  • Malvern, PA
National Provider Identifier
1699207407
Registry record updated Aug 30, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
License
MD477645 Issued in PA
Practice address
414 Paoli Pike
Malvern, PA 19355-3311
Phone
(484) 596-5000
NPI assigned
Mar 30, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 30, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation Physician 208100000X MT213694 PA
Physical Medicine & Rehabilitation Physician 208100000X MD477645 PA Primary

Addresses

Primary practice location

414 Paoli Pike
Malvern, PA 19355-3311

Mailing address

200 High Pointe Dr Apt 212
Hummelstown, PA 17036-8103

Other practice location 1

1800 Lombard St
Philadelphia, PA 19146-1414
Phone (215) 893-2676

Other practice location 2

1135 Olde W Chocolate Ave
Hummelstown, PA 17036-9188
Phone (717) 832-2600

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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
I20220718002941 PA Practitioner - Physical Medicine and Rehabilitation 2961753595 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Medicine and Rehabilitation
Education
Rutgers R W Johnson Medical School (Cam/New Bruns/Pisc), 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Suburban Medical Group LLCGroup PAC ID 6204145642, 29 clinicians

Practice addresses (Care Compare)

5735 Ridge Ave
Suite 106
Philadelphia, PA 19128-1746
Phone (215) 487-1887

Hospital & facility affiliations

  • Roxborough Memorial Hospital Hospital, Philadelphia, PA, CCN 390304
  • Temple University Hospital Hospital, Philadelphia, PA, CCN 390027
  • Roxborough Memorial Hospital Inpatient rehabilitation facility, Philadelphia, PA, CCN 39T304

Merit-based Incentive Payment System (MIPS)

Final score
87.66 of 100Reported as group
Quality
73.72
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD477645PAMDPhysical Medicine & Rehabilitation Physician
MT213694PAMDPhysical Medicine & Rehabilitation Physician

Practice roles

OrganizationSpecialtyStatusNew patients
National Health Rehabilitation LLC Physical Medicine & Rehabilitation CurrentSince Jan 16, 2023 Accepting new patients
Suburban Medical Group LLC CurrentSince Sep 5, 2024 Accepting new patients
Prime Healthcare Services Roxborough LLC Past Accepting new patients
Medical Associates of the Main Line, PC PastSince Mar 12, 2024 Accepting new patients

Locations

3000 Hilltop Rd
Whiting, NJ 08759
Phone (732) 849-4400

2701 DeKalb Pike
Fl 2
East Norriton, PA 19401
Phone (610) 275-1028

2050 Old West Chester Pike
Havertown, PA 19083
Phone (610) 449-8600

5735 Ridge Ave
Ste 106
Philadelphia, PA 19128
Phone (215) 482-2412

184 Bethlehem Pike
Philadelphia, PA 19118
Phone (215) 247-5311

1113 Easton Rd
Willow Grove, PA 19090
Phone (215) 659-3060

1770 Barley Rd
York, PA 17408
Phone (717) 755-8811

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 10

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": "1490832000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1661817600000",
    "number": "1699207407",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 HIGH POINTE DR APT 212",
            "city": "HUMMELSTOWN",
            "state": "PA",
            "postal_code": "170368103"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "414 PAOLI PIKE",
            "city": "MALVERN",
            "state": "PA",
            "postal_code": "193553311",
            "telephone_number": "484-596-5000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1800 Lombard St",
            "address_purpose": "LOCATION",
            "city": "Philadelphia",
            "state": "PA",
            "postal_code": "191461414",
            "country_code": "US",
            "telephone_number": "215-893-2676",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1135 Olde W Chocolate Ave",
            "address_purpose": "LOCATION",
            "city": "Hummelstown",
            "state": "PA",
            "postal_code": "170369188",
            "country_code": "US",
            "telephone_number": "717-832-2600",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SCHUPP",
        "first_name": "ALFRED",
        "name_prefix": "Dr.",
        "name_suffix": "III",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-03-30",
        "last_updated": "2022-08-30",
        "certification_date": "2022-08-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "PA",
            "license": "MT213694",
            "primary": false
        },
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "PA",
            "license": "MD477645",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Malvern, PA

Sources for this page

Verify at the official NPI Registry.