Individual provider Active NPI

Michelle Kupshik

  • Anesthesiologist Assistant
  • Atlanta, GA
National Provider Identifier
1932518933
Registry record updated Aug 5, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiologist AssistantTaxonomy code 367H00000X
Practice address
1364 Clifton Rd NE
Atlanta, GA 30322-1059
Phone
(404) 313-0862
NPI assigned
Aug 5, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 5, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiologist Assistant 367H00000X Primary

Addresses

Primary practice location

1364 Clifton Rd NE
Atlanta, GA 30322-1059

Mailing address

1364 Clifton Rd NE
Atlanta, GA 30322-1059
Phone (404) 313-0862

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA, SC2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20141201001238 GA Practitioner - Anesthesiology Assistant 8921320060 Reassigns benefits to 2 organizations
I20210817003877 SC Practitioner - Anesthesiology Assistant 8921320060 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology Assistant
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Coastal Anesthesia Associates LLCGroup PAC ID 9032022744, 16 clinicians
Trident Anesthesia Group LLCGroup PAC ID 5294631545, 121 clinicians

Practice addresses (Care Compare)

130 Edge St
Summerville, SC 29486-3002
Phone (843) 764-0992

9313 Medical Plaza Dr
Suite 102
Charleston, SC 29406-9153
Phone (843) 797-8992

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Bon Secours St. Francis Xavier Hospital, Inc. CurrentSince Feb 1, 2022 Accepting new patients
Bon Secours St Francis Xavier Hospital, Inc. Current Accepting new patients
Coastal Anesthesia Associates, LLC CurrentSince Aug 1, 2021 Accepting new patients
The Emory Clinic Inc CurrentSince Oct 6, 2014 Accepting new patients
Trident Anesthesia Group, LLC CurrentSince Aug 1, 2021 Accepting new patients
Au Medical Associates Anesthesia Billing Services, LLC CurrentSince Aug 1, 2018 Accepting new patients
Bon Secours St. Francis Xavier Hospital, Inc. CurrentSince Feb 1, 2022 Accepting new patients

Locations

1365 Clifton Rd NE
Atlanta, GA 30322
Phone (404) 778-7525

1120 15th St
Augusta, GA 30912
Phone (706) 721-3873

101 W Ponce de Leon Ave
Ste 300
Decatur, GA 30030
Phone (404) 778-4889

2095 Henry Tecklenburg Dr
Charleston, SC 29414
Phone (843) 402-1037

423 Barony St
Moncks Corner, SC 29461

9263 Medical Plaza Dr
Ste E
North Charleston, SC 29406
Phone (843) 572-1228

9313 Medical Plaza Dr
Ste 102
North Charleston, SC 29406
Phone (843) 572-1228

130 Edge St
Summerville, SC 29486
Phone (843) 628-5816

Organizations & group practices 7

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": "1407196800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1407196800000",
    "number": "1932518933",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1364 CLIFTON RD NE",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303221059",
            "telephone_number": "404-313-0862"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1364 CLIFTON RD NE",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303221059",
            "telephone_number": "404-313-0862"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KUPSHIK",
        "first_name": "MICHELLE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-08-05",
        "last_updated": "2014-08-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367H00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiologist Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.