Madison Joan Rupnik, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA9115052 Issued in FL

Practice address

16646 N Dale Mabry Hwy
Tampa, FL 33618-1400

Phone

(813) 908-5253

Fax

(813) 355-5895

NPI assigned

Oct 8, 2021

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

K Wade Foster MD PAGroup PAC ID 3173663374, 17 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

Networks

• Freedom Health HMO Network

Interoperability endpoints

• Direct secure messaging: mrupnik@centralflderm.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.

• K Wade Foster MD PA

  dba Florida Dermatology & Skin Cancer Centers

  • MOHS-Micrographic Surgery Physician
  • Winter Haven, FL
  • NPI 1205066404
  Medicare reassignment Care Compare group
• Florida Medical Clinic LLC

  • Clinic/Center
  • Zephyrhills, FL
  • NPI 1821055690
  Medicare reassignment NPD
• Florida Medical Clinic, LLC

  dba Florida Medical Clinic Pharmacy

  • Pharmacy
  • Zephyrhills, FL
  • NPI 1669548020
  NPD

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

{
    "created_epoch": "1633651200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1633651200000",
    "number": "1821750639",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "38135 MARKET SQ",
            "city": "ZEPHYRHILLS",
            "state": "FL",
            "postal_code": "335427505",
            "telephone_number": "352-567-0188",
            "fax_number": "813-355-5101"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16646 N DALE MABRY HWY",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336181400",
            "telephone_number": "813-908-5253",
            "fax_number": "813-355-5895"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUPNIK",
        "first_name": "MADISON",
        "middle_name": "JOAN",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-10-08",
        "last_updated": "2021-10-08",
        "certification_date": "2021-10-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9115052",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kristina Runyan
• Lisa Pergament Runyon, LMHC4906
• Jessica Rupe-Haven, PT
• Amanda Catherine Rupert, CNP
• Brooke Alecia Rupert, ARNP
• Cory James Ruppel, D.D.S.
• Solveig B. Ruppel, DDS
• Nola Doreen Rupprecht, CRNA
• Isla H Ruprai, CRNA
• Alfred Izell Rush III, NURSE PRACTITIONER

• Physician Assistant in Tampa, FL
• Providers in Tampa, FL by specialty
• Physician Assistant in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 8, 2021; 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.