Madison Soupiset, DPT, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

2305216272 Issued in VA

Practice address

12825 Minnieville Rd Ste 203
Lake Ridge, VA 22192-3602

Phone

(703) 647-3130

NPI assigned

Nov 17, 2023

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in DC

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2023

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Fusion Physiotherapy Associates LLCGroup PAC ID 5092093575, 19 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Fusion Physiotherapy Associates LLC

  • Physical Therapist
  • Fredericksburg, VA
  • NPI 1730530213

  DC

  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1700179200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707091200000",
    "number": "1942075171",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5706 FLAGLER DR",
            "city": "CENTREVILLE",
            "state": "VA",
            "postal_code": "201202959",
            "telephone_number": "319-600-2200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12825 MINNIEVILLE RD STE 203",
            "city": "LAKE RIDGE",
            "state": "VA",
            "postal_code": "221923602",
            "telephone_number": "703-647-3130"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SOUPISET",
        "first_name": "MADISON",
        "credential": "DPT, PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-11-17",
        "last_updated": "2024-02-05",
        "certification_date": "2024-02-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "VA",
            "license": "2305216272",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Serenity Women'S Healthcare LLC
• Kayla Sharma
• Jea Yeon Shin
• Andrew Lawrence Shipp, PT, DPT
• Althea Simpson, LCSW
• Douglas Edward Stabile, DPM
• Kimberly Strand, PHD
• Steven Walter Swann, M.D.
• Muneeza Syed
• Sana Syed

• Physical Therapist in Lake Ridge, VA
• Providers in Lake Ridge, VA by specialty
• Physical Therapist in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 5, 2024; 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.