Individual provider Active NPI

Amanda Kupstas, M.D.

  • Surgery Physician
  • Brighton, MI
National Provider Identifier
1831539071
Registry record updated Aug 22, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
4301103795 Issued in MI
Practice address
2305 Genoa Business Park Dr Ste 210
Brighton, MI 48114-7005
Phone
(734) 712-1700
NPI assigned
Jul 2, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 4301103795 MI Primary
Surgery Physician 208600000X 63689 MN

Addresses

Primary practice location

2305 Genoa Business Park Dr Ste 210
Brighton, MI 48114-7005

Mailing address

24 Frank Lloyd Wright Dr Ste J2000
Ann Arbor, MI 48105-9484
Phone (734) 747-6766

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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 1

Enrollment IDStateProvider typePAC IDDetails
I20190807002796 MI Practitioner - Surgical OncologyPractitioner - General Surgery 9931457462 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Surgical OncologyAlso: General Surgery
Education
Wayne State University School of Medicine, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Iha Health Services CorporationGroup PAC ID 2466351440, 1,149 clinicians

Practice addresses (Care Compare)

2305 Genoa Nusiness Park Dr
Suite 210
Brighton, MI 48197-7005
Phone (734) 712-1700

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Mastectomy66
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4301103795MIMDSurgery Physician
63689MNMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Iha Health Service Corporation CurrentSince Aug 2, 2019 Accepting new patients
Iha Health Services Corporation Surgery CurrentSince Aug 2, 2019 Accepting new patients
Iha Health Services Corporation Current Accepting new patients
Iha Health Services Corporation Past Accepting new patients

Locations

24 Frank Lloyd Wright Dr
Ann Arbor, MI 48105
Phone (734) 930-7400

2305 Genoa Business Park Dr
Ste 210
Brighton, MI 48114
Phone (734) 712-1700

2305 Genoa Business Park Dr
Ste 200
Brighton, MI 48114
Phone (810) 494-6840

128 Van Buren St
Chelsea, MI 48118
Phone (734) 475-8677

14555 Levan Rd
Ste 113
Livonia, MI 48154
Phone (734) 655-8817

44428 Woodward Ave
Ste 102
Pontiac, MI 48341
Phone (734) 712-8700

4990 W Clark Rd
Ste 200
Ypsilanti, MI 48197
Phone (734) 572-7500

Interoperability endpoints

  • Direct secure messaging: akupstas44508@direct.trinity-health.org

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.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1372723200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1566432000000",
    "number": "1831539071",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24 FRANK LLOYD WRIGHT DR STE J2000",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481059484",
            "telephone_number": "734-747-6766"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2305 GENOA BUSINESS PARK DR STE 210",
            "city": "BRIGHTON",
            "state": "MI",
            "postal_code": "481147005",
            "telephone_number": "734-712-1700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KUPSTAS",
        "first_name": "AMANDA",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-07-02",
        "last_updated": "2019-08-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "MI",
            "license": "4301103795",
            "primary": true
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "MN",
            "license": "63689",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brighton, MI

Sources for this page

Verify at the official NPI Registry.