Individual provider Active NPI

Larisa Kupershmid, FNP

  • Family Nurse Practitioner
  • Brooklyn, NY
National Provider Identifier
1831909027
Registry record updated Jan 9, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
F355134 Issued in NY
Practice address
2331 Stillwell Ave
Brooklyn, NY 11223-5647
Phone
(646) 530-4833
NPI assigned
Jan 9, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 9, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X F355134 NY Primary

Addresses

Primary practice location

2331 Stillwell Ave
Brooklyn, NY 11223-5647

Mailing address

2804 E 19TH St Apt PH2
Brooklyn, NY 11235-3316
Phone (917) 215-4485

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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

Enrollment IDStateProvider typePAC IDDetails
I20250527001784 NY Practitioner - Nurse Practitioner 0648799353 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
F355134NYMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
US Rehabilitation Medicine Consulting, PLLC CurrentSince Apr 1, 2025 Accepting new patients
Interventional Physical Medicine and Rehab of New York, PLLC CurrentSince Apr 1, 2025 Accepting new patients
Kumar Medical Pain Management PC Past Accepting new patients

Locations

53 Brentwood Rd
Ste F
Bay Shore, NY 11706
Phone (631) 647-5546

4564 Francis Lewis Blvd
Ste 200
Bayside, NY 11361
Phone (516) 888-7614

250 Beach 17th St
Far Rockaway, NY 11691
Phone (516) 670-0212

2241 New Haven Ave
Far Rockaway, NY 11691
Phone (516) 888-7614

15 Saint Pauls Pl
Great Neck Plaza, NY 11021
Phone (516) 466-3001

3000 Hempstead Tpke
Ste 112
Levittown, NY 11756
Phone (516) 888-7614

970 Wellwood Ave
Lindenhurst, NY 11757
Phone (631) 225-1289

1615 Northern Blvd
#4
Manhasset, NY 11030

1615 Northern Blvd
Ste GR4
Manhasset, NY 11030
Phone (516) 888-7614

1615 Northern Blvd
Ste GR1
Manhasset, NY 11030
Phone (516) 823-6570

1615 Northern Blvd
#1
Manhasset, NY 11030
Phone (516) 888-7614

25 Schoenfeld Blvd
Patchogue, NY 11772
Phone (631) 289-7700

140 W Merrick Rd
Valley Stream, NY 11580
Phone (516) 888-7614

138 Hillside Ave
Williston Pk, NY 11596
Phone (516) 509-8599

1050 Central Ave
Woodmere, NY 11598
Phone (516) 374-9300

Networks

  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H1722

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/GFJEDD

Organizations & group practices 3

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": "1736380800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736380800000",
    "number": "1831909027",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2804 E 19TH ST APT PH2",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112353316",
            "telephone_number": "917-215-4485"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2331 STILLWELL AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112235647",
            "telephone_number": "646-530-4833"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KUPERSHMID",
        "first_name": "LARISA",
        "name_prefix": "Mrs.",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-01-09",
        "last_updated": "2025-01-09",
        "certification_date": "2025-01-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "F355134",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.