Individual provider Active NPI

Megan A Chupka-Fuson, DPT

  • Physical Therapist
  • Elk Rapids, MI
National Provider Identifier
1972930238
Registry record updated May 10, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
5501016486 Issued in MI
Practice address
128 Ames St
Elk Rapids, MI 49629-9739
Phone
(231) 264-6682
Fax
(231) 264-9188
NPI assigned
Oct 2, 2013
Last updated
May 10, 2016By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 10, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 5501016486 MI Primary

Addresses

Primary practice location

128 Ames St
Elk Rapids, MI 49629-9739

Mailing address

1650 Barlow St
Traverse City, MI 49686-4721
Phone (231) 941-3100

Other names 1

  • Megan A Chupka Former name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140102001102 MI Practitioner - Physical Therapist in Private Practice 8325276074 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Functional Dimensions, LLCGroup PAC ID 6608026190, 11 clinicians

Practice addresses (Care Compare)

3899 W Front St
Suite 3
Traverse City, MI 49684-8104
Phone (231) 944-6541

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5501016486MIMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Functional Dimensions LLC Physical Therapist CurrentSince Jun 12, 2017 Accepting new patients
Functional Dimensions LLC Physical Therapist CurrentSince Dec 16, 2020 Accepting new patients

Locations

3899 W Front St
Ste 3
Traverse City, MI 49684
Phone (231) 421-9277

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1380672000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1462838400000",
    "number": "1972930238",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1650 BARLOW ST",
            "city": "TRAVERSE CITY",
            "state": "MI",
            "postal_code": "496864721",
            "telephone_number": "231-941-3100",
            "fax_number": "231-922-0382"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "128 AMES ST",
            "city": "ELK RAPIDS",
            "state": "MI",
            "postal_code": "496299739",
            "telephone_number": "231-264-6682",
            "fax_number": "231-264-9188"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHUPKA-FUSON",
        "first_name": "MEGAN",
        "middle_name": "A",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-10-02",
        "last_updated": "2016-05-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MI",
            "license": "5501016486",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MEGAN",
            "last_name": "CHUPKA",
            "middle_name": "A",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Elk Rapids, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 10, 2016; 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.