Active NPI
Annelise Marie Lupica, M.D.
- Pediatrics Physician
- New York, NY
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- 300156
- Practice address
- 3985 Broadway
New York, NY 10032 - Phone
- (917) 305-6059
- NPI assigned
- Jun 9, 2016
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 300156 | NY | Primary |
| Pediatrics Physician | 208000000X | A168984 | CA |
Addresses
Primary practice location
3985 Broadway
New York, NY 10032
Mailing address
229 W 116TH St Apt 5a
New York, NY 10026-2799
Phone (818) 720-9655
Electronic endpoints 3
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| FHIR URL | https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/DSTU2/ | Health Information Exchange (HIE) | |
| FHIR URL | https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/R4/ | Health Information Exchange (HIE) | |
| Direct Messaging Address | UEK9002@direct.nyp.org | Direct |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NY, CA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 2
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| A168984 | CA | MD | Pediatrics Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Trustees of Columbia University in the City of New York | Pediatrics | Current | Accepting new patients |
| Bronxcare Health System | Current | Accepting new patients | |
| St. Johns Community Health | Current | Accepting new patients | |
| Trustees of Columbia University in the City of New York | Current | Accepting new patients | |
| Children'S Hospital Los Angeles Medical Group, Inc. | Pediatrics | Current | Accepting new patients |
| St. Johns Community Health | Current | Accepting new patients | |
| St. Johns Community Health | Current | Accepting new patients | |
| Bronxcare Health System | Pediatrics | Current | Accepting new patients |
| Trustees of Columbia University in the City of New York | Current | Accepting new patients |
Locations
2115 N Wilmington Ave
Compton, CA 90222
Phone (310) 603-1332
3701 Wilshire Blvd
Ste 600
Los Angeles, CA 90010
Phone (323) 361-3550
4650 W Sunset Blvd
Los Angeles, CA 90027
Phone (323) 361-2122
1650 Grand Concourse
Bronx, NY 10457
Phone (718) 294-7104
1276 Fulton Ave
Bronx, NY 10456
Phone (718) 518-5000
1650 Grand Concourse
Fl 3
Bronx, NY 10457
Phone (718) 518-5046
161 Fort Washington Ave
New York, NY 10032
Phone (212) 305-8559
622 W 168th St
New York, NY 10032
Phone (212) 305-4931
622 W 168th St
#2260
New York, NY 10032
Phone (212) 305-6204
Interoperability endpoints
- uek9002@direct.nyp.org
- https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/R4/
- https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/DSTU2/
Organizations & group practices 9
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.
-
- Surgery Physician
- New York, NY
- NPI 1508266347
Pediatrics
-
- Multi-Specialty Clinic/Center
- Los Angeles, CA
- NPI 1265530653
Pediatrics
-
- Federally Qualified Health Center (FQHC)
- Los Angeles, CA
- NPI 1073653630
-
- Methadone Clinic
- Bronx, NY
- NPI 1801428222
-
- Anesthesiology Physician
- New York, NY
- NPI 1477068971
-
- Internal Medicine Physician
- New York, NY
- NPI 1699289488
-
- Community Health Clinic/Center
- Los Angeles, CA
- NPI 1073363768
-
- Federally Qualified Health Center (FQHC)
- Los Angeles, CA
- NPI 1396981700
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1465430400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1711152000000",
"number": "1790134880",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "229 W 116TH ST APT 5A",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100262799",
"telephone_number": "818-720-9655"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3985 BROADWAY",
"city": "NEW YORK",
"state": "NY",
"postal_code": "10032",
"telephone_number": "917-305-6059"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LUPICA",
"first_name": "ANNELISE",
"middle_name": "MARIE",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-06-09",
"last_updated": "2024-03-23",
"certification_date": "2024-03-23",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "NY",
"license": "300156",
"primary": true
},
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "CA",
"license": "A168984",
"primary": false
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "FHIR",
"endpointTypeDescription": "FHIR URL",
"endpoint": "https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/DSTU2/",
"affiliation": "N",
"endpointDescription": "FHIR",
"use": "HIE",
"useDescription": "Health Information Exchange (HIE)",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "FHIR",
"address_1": "3985 Broadway",
"city": "New York",
"state": "NY",
"country_code": "US",
"postal_code": "10032",
"country_name": "United States",
"address_type": "DOM"
},
{
"endpointType": "FHIR",
"endpointTypeDescription": "FHIR URL",
"endpoint": "https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/R4/",
"affiliation": "N",
"endpointDescription": "FHIR",
"use": "HIE",
"useDescription": "Health Information Exchange (HIE)",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "FHIR",
"address_1": "3985 Broadway",
"city": "New York",
"state": "NY",
"country_code": "US",
"postal_code": "10032",
"country_name": "United States",
"address_type": "DOM"
},
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "UEK9002@direct.nyp.org",
"affiliation": "N",
"endpointDescription": "Direct Address",
"use": "DIRECT",
"useDescription": "Direct",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "Direct Address",
"address_1": "3985 Broadway",
"city": "New York",
"state": "NY",
"country_code": "US",
"postal_code": "10032",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in New York, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 23, 2024; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.