Individual provider Active NPI

Nicholas Carlo Lupano, DO

  • Emergency Medicine Physician
  • Lawton, OK
National Provider Identifier
1780375212
Registry record updated Oct 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
8694 Issued in OK
Practice address
3401 W Gore Blvd # L
Lawton, OK 73505-6332
Phone
(580) 355-8620
NPI assigned
May 16, 2023
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 23, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Emergency Medicine Physician 207P00000X 8694 OK Primary

Addresses

Primary practice location

3401 W Gore Blvd # L
Lawton, OK 73505-6332

Mailing address

3401 W Gore Blvd # L
Lawton, OK 73505-6332

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK, NJ2 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 2

Enrollment IDStateProvider typePAC IDDetails
I20241218003526 OK Practitioner - Emergency Medicine 3173050945 Reassigns benefits to 3 organizations
I20260622001327 NJ Practitioner - Emergency Medicine 3173050945 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Touro Un Col of Osteopathic Medicine, Henderson, 2023
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1 Zotec Way
Carmel, IN 46032-0052

PO Box
Newark, NJ 07101

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
HCC Duncan Inc CurrentSince Nov 2, 2024 Accepting new patients
Arbuckle Memorial Hospital Current Accepting new patients
Emergency Physicians of Mid-America, P.C. Emergency Medicine CurrentSince May 1, 2025 Accepting new patients

Locations

1407 N Whisenant Dr
Duncan, OK 73533
Phone (580) 251-8458

1500 N Green Ave
Purcell, OK 73080
Phone (405) 527-2250

1102 W MacArthur St
Shawnee, OK 74804
Phone (405) 273-2270

2011 W Broadway Ave
Sulphur, OK 73086
Phone (580) 622-2161

3701 E Main St
Weatherford, OK 73096
Phone (580) 772-5551

Interoperability endpoints

  • Direct secure messaging: nlupano537330@direct-ehr-ssmhc.com

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.

NPI Registry JSON

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

{
    "created_epoch": "1684195200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729641600000",
    "number": "1780375212",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3401 W GORE BLVD # L",
            "city": "LAWTON",
            "state": "OK",
            "postal_code": "735056332"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3401 W GORE BLVD # L",
            "city": "LAWTON",
            "state": "OK",
            "postal_code": "735056332",
            "telephone_number": "580-355-8620"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUPANO",
        "first_name": "NICHOLAS",
        "middle_name": "CARLO",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-05-16",
        "last_updated": "2024-10-23",
        "certification_date": "2024-10-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "OK",
            "license": "8694",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lawton, OK

Sources for this page

Verify at the official NPI Registry.