Active NPI
Brett Schupack, DO
- Emergency Medicine Physician
- Brooklyn, NY
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Emergency Medicine Physician
- License
- 036163454
- Practice address
- 506 6TH St
Department of Emergency Medicine
Brooklyn, NY 11215-3609 - Phone
- (718) 780-5040
- NPI assigned
- Jun 27, 2016
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Emergency Medicine Physician | 207P00000X | 2020014926 | MO | |
| Emergency Medicine Physician | 207P00000X | 298861 | NY | |
| Emergency Medicine Physician | 207P00000X | 036163454 | IL | Primary |
Addresses
Primary practice location
506 6TH St
Department of Emergency Medicine
Brooklyn, NY 11215-3609
Mailing address
506 6TH St
Department of Emergency Medicine
Brooklyn, NY 11215-3609
Phone (718) 780-5040
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NY, MO, IL
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 3
Care Compare profile
Medicare Care Compare- Specialty
- Emergency Medicine
- Education
- Touro Un Col of Osteopathic Medicine, New York, 2016
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
1008 N Main St
Sikeston, MO 63801-5044
Phone (573) 471-1600
12303 De Paul Dr
Bridgeton, MO 63044-2512
Phone (314) 344-6000
503 N Maple St
Effingham, IL 62401-2006
Phone (217) 347-1211
Hospital & facility affiliations
Merit-based Incentive Payment System (MIPS)
- Final score
- 93.41 of 100
- Quality
- 86.81
- Improvement activities
- 40
- Cost
- 77.34
Merit-based Incentive Payment System (MIPS)
- Final score
- 91.05 of 100
- Quality
- 65.2
- Improvement activities
- 40
Merit-based Incentive Payment System (MIPS)
- Final score
- 87.3 of 100
- Quality
- 70.94
- Improvement activities
- 40
- Cost
- 92.94
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2020014926 | MO | MD | Emergency Medicine Physician |
| 298861 | NY | MD | Emergency Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Cepamerica Illinois LLP | Emergency Medicine | Current | Accepting new patients |
| Cep America LLC | Emergency Medicine | Current | Accepting new patients |
| Cepamerica Illinois LLP | Emergency Medicine | Current | Accepting new patients |
| Cep America LLC | Emergency Medicine | Current | Accepting new patients |
| Cep America, LLC | Emergency Medicine | Current | Accepting new patients |
| Cepamerica Illinois LLP | Emergency Medicine | Current | Accepting new patients |
| Sikeston Emergency Group LLC | Emergency Medicine | Current | Accepting new patients |
Locations
1601 Cummins Dr
Ste D
Modesto, CA 95358
Phone (510) 350-2663
4500 Memorial Dr
Belleville, IL 62226
Phone (618) 233-7750
503 N Maple St
Effingham, IL 62401
Phone (217) 342-2121
1 Saint Elizabeth Blvd
O Fallon, IL 62269
Phone 618234212012438
12303 De Paul Dr
Bridgeton, MO 63044
Phone (314) 344-6360
1015 Bowles Ave
Fenton, MO 63026
Phone (636) 496-2000
10010 Kennerly Rd
Saint Louis, MO 63128
Phone (314) 525-1328
1008 N Main St
Sikeston, MO 63801
Phone (573) 471-1600
Organizations & group practices 7
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.
-
- Emergency Medicine Physician
- Elgin, IL
- NPI 1912283110
-
- Emergency Medicine Physician
- Sikeston, MO
- NPI 1427575299
-
- Emergency Medicine Physician
- Fort Lauderdale, FL
- NPI 1700747946
-
- Emergency Medicine Physician
- Bridgeton, MO
- NPI 1851946370
-
- Emergency Medicine Physician
- Highland, IL
- NPI 1275032179
-
- Emergency Medicine Physician
- Springfield, IL
- NPI 1871360297
Hospital & facility affiliations 4
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Sikeston, MO
- NPI 1831269539
-
dba SSM Health DePaul Hospital - St. Louis
- General Acute Care Hospital
- Bridgeton, MO
- NPI 1598835308
-
dba St. Anthony's Memorial Hospital
- General Acute Care Hospital
- Effingham, IL
- NPI 1306800602
-
dba St. Anthony's Memorial Hospitral
- Clinic/Center
- Effingham, IL
- NPI 1881214104
Hospital
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1466985600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1675728000000",
"number": "1780035139",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "506 6TH ST",
"address_2": "DEPARTMENT OF EMERGENCY MEDICINE",
"city": "BROOKLYN",
"state": "NY",
"postal_code": "112153609",
"telephone_number": "718-780-5040"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "506 6TH ST",
"address_2": "DEPARTMENT OF EMERGENCY MEDICINE",
"city": "BROOKLYN",
"state": "NY",
"postal_code": "112153609",
"telephone_number": "718-780-5040"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SCHUPACK",
"first_name": "BRETT",
"name_prefix": "Dr.",
"credential": "DO",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2016-06-27",
"last_updated": "2023-02-07",
"certification_date": "2023-02-07",
"status": "A"
},
"taxonomies": [
{
"code": "207P00000X",
"taxonomy_group": "",
"desc": "Emergency Medicine",
"state": "MO",
"license": "2020014926",
"primary": false
},
{
"code": "207P00000X",
"taxonomy_group": "",
"desc": "Emergency Medicine",
"state": "NY",
"license": "298861",
"primary": false
},
{
"code": "207P00000X",
"taxonomy_group": "",
"desc": "Emergency Medicine",
"state": "IL",
"license": "036163454",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Brooklyn, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 7, 2023; 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.