Individual provider Active NPI

Sofia Edda Capua, PA-C

  • Surgical Physician Assistant
  • Springfield, MA
National Provider Identifier
1942876750
Registry record updated Sep 4, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
PA8127 Issued in MA
Practice address
3455 Main St Ste 5
Springfield, MA 01107-1142
Phone
(413) 733-9600
Fax
(413) 732-6534
NPI assigned
Jun 2, 2021
Last updated
Sep 4, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 4, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X PA8127 MA Primary

Addresses

Primary practice location

3455 Main St Ste 5
Springfield, MA 01107-1142

Mailing address

3455 Main St Ste 5
Springfield, MA 01107-1142
Phone (413) 733-9600

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
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
I20210812003617 MA Practitioner - Physician Assistant 1153725130 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
New England Dermatology PCGroup PAC ID 9436113677, 21 clinicians

Practice addresses (Care Compare)

3455 Main St
Suite 5
Springfield, MA 01107-1147
Phone (413) 733-9600

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Northeast Orthopaedic Alliance PLLC CurrentSince Mar 27, 2024 Accepting new patients
Northeast Orthopaedic Alliance PLLC CurrentSince Mar 27, 2024 Accepting new patients
New England Orthopedic Surgeons CurrentSince Sep 1, 2021 Accepting new patients
New England Orthopedic Surgeons CurrentSince Sep 1, 2021 Accepting new patients

Locations

300 Birnie Ave
Springfield, MA 01107
Phone (413) 736-5649

300 Birnie Ave
Ste 201
Springfield, MA 01107
Phone (413) 233-1292

150 Flanders Rd
Westborough, MA 01581
Phone (508) 870-2222

Organizations & group practices 5

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.

Hospital & facility affiliations 2

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": "1622592000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1725408000000",
    "number": "1942876750",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3455 MAIN ST STE 5",
            "city": "SPRINGFIELD",
            "state": "MA",
            "postal_code": "011071142",
            "telephone_number": "413-733-9600",
            "fax_number": "413-732-6534"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3455 MAIN ST STE 5",
            "city": "SPRINGFIELD",
            "state": "MA",
            "postal_code": "011071142",
            "telephone_number": "413-733-9600",
            "fax_number": "413-732-6534"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CAPUA",
        "first_name": "SOFIA",
        "middle_name": "EDDA",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-06-02",
        "last_updated": "2024-09-04",
        "certification_date": "2024-09-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "MA",
            "license": "PA8127",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Springfield, MA

Sources for this page

Verify at the official NPI Registry.