Adrienne Schupbach, M.D.

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

2022005842 Issued in MO

Practice address

3024 E Empire St Ste E&F
Bloomington, IL 61704-5402

Phone

(309) 451-3376

NPI assigned

May 19, 2009

Last updated

Jun 14, 2022By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in IL, MO, FL, LA4 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 4

Specialty

Dermatology

Education

University of Illinois College of Med (CHI/Peor/Rock/CHM-Urb), 2009

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Dermatology and Mohs Surgery Skin Cancer CenterGroup PAC ID 8527447945, 8 clinicians

Cenla DermatologyGroup PAC ID 0446679161, 6 clinicians

Dermatology and Skin Cancer CenterGroup PAC ID 2668821919, 6 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

86.43 of 100Reported as individual

Quality

76.96

Promoting interoperability

97

Improvement activities

40

Merit-based Incentive Payment System (MIPS)

Final score

92.71 of 100Reported as group

Quality

97.78

Promoting interoperability

100

Improvement activities

40

Cost

77.93

Merit-based Incentive Payment System (MIPS)

Final score

75 of 100Reported as group

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: aschupbach@coastalskinsurgery.emadirect.md
• Direct secure messaging: aschupbach@dermandmohs.emadirect.md
• Direct secure messaging: aschupbach@dms.emadirect.md

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Dermatology and Skin Cancer Center

  • Dermatology Physician
  • Bloomington, IL
  • NPI 1093596652
  Medicare reassignment Care Compare group NPD Authorized official
• Dermatology and Mohs Surgery Skin Cancer Center

  • Dermatology Physician
  • Branson, MO
  • NPI 1124763479
  Medicare reassignment Care Compare group NPD Authorized official
• Cenla Dermatology

  • Dermatology Physician
  • Alexandria, LA
  • NPI 1851919005
  Medicare reassignment Care Compare group NPD
• Coastal Skin Surgery and Dermatology, PL

  • MOHS-Micrographic Surgery Physician
  • Miramar Beach, FL
  • NPI 1114238193

  Dermatology

  Medicare reassignment NPD
• The Vein Specialists, LLC

  • Emergency Medical Services (Emergency Medicine) Physician
  • Bloomington, IL
  • NPI 1861703100
  NPD
• Carle Bromenn Medical Center

  dba Advocate BroMenn Medical Center

  • General Acute Care Hospital
  • Normal, IL
  • NPI 1962424036
  NPD (past)
• Mike Swann, MD, LLC

  dba Swann Dermatology & Esthetics

  • Procedural Dermatology Physician
  • Springfield, MO
  • NPI 1689907081
  NPD (past)

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

{
    "created_epoch": "1242691200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1655164800000",
    "number": "1740415777",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 BUSINESS PARK DR STE C",
            "city": "BRANSON",
            "state": "MO",
            "postal_code": "656167449",
            "telephone_number": "417-336-0033",
            "fax_number": "417-239-0127"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3024 E EMPIRE ST STE E&F",
            "city": "BLOOMINGTON",
            "state": "IL",
            "postal_code": "617045402",
            "telephone_number": "309-451-3376"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHUPBACH",
        "first_name": "ADRIENNE",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-05-19",
        "last_updated": "2022-06-14",
        "certification_date": "2022-06-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "IL",
            "license": "036.131823",
            "primary": false
        },
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "MO",
            "license": "2022005842",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Martin J Schroeder, MD
• Melissa Schruck, CCC, SLP-L
• Samantha Schuckles
• Kevin Kelso Schultz, DDS
• Jessica Ann Schulzki, BEHAVIOR ANALYST
• Darla Schwertfeger, RN, CNIM
• Marta Halina Sciubisz, M.D.
• Stephanie Scolaro, PHARM.D.
• Alancia M Scott
• Anthony Joseph Scott

• Dermatology Physician in Bloomington, IL
• Providers in Bloomington, IL by specialty
• Dermatology Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 14, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.