DOREEN KAY PUPO (CRNP) – Nurse Practitioner, NPI 1194086868

DOREEN KAY PUPO (CRNP) is a healthcare provider. based in Philadelphia, Pennsylvania. specializing in NURSE PRACTITIONER. They hold the professional credentials CRNP. They hold a License No. SP011849 (PA). The NPI Number for DOREEN KAY PUPO (CRNP) is 1194086868

Main info

Female
15 Years Of Experience
Accepts Medicare Assignment
Name
DOREEN KAY PUPO (CRNP)
NPI
1194086868
Phone
(215) 888-3250
Address
2333 ELLSWORTH ST
Enumeration Date
30 May 2012
Last Update Date
29 May 2024

Doctor Profile

Medical School Name
OTHER
Secondary Phone
6102728221
Graduation Year
2011 (15 years ago)
PAC ID
1153571666
Group Practice PAC ID
9537552419
Professional Enrollment ID
I20121018000357
Address ID
PA194622324PL2901XRDXX300
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience52
Completeness75
Years active:14State licenses:1Digital endpointsOther names

11,473 NURSE PRACTITIONER in PA

Provider Addresses for DOREEN KAY PUPO (CRNP)

  • 2333 ELLSWORTH ST

    PHILADELPHIA, PA 191462419

    Phone: (215) 888-3250

    Type: Mailing

  • 3401 N BROAD ST

    4TH FLOOR ZONE C

    PHILADELPHIA, PA 191405103

    Phone: (215) 707-8951

    Type: Location

  • 679 SPROUL RD

    BRYN MAWR, PA 190101112

    Phone: (215) 888-3250

    Type: Mailing

  • 2901 JOLLY RD

    PLYMOUTH MEETING, PA 194622324

    Phone: (610) 272-8221

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 1 Open Payments records for all available years, with a total value of $14.

Total Amount is formed as General ($14) + Research ($0) + Ownership ($0) = $14.

Last reported payment date: 2024-03-01 • Largest payer in this snapshot: Smith+Nephew, Inc. ($14).

Total Amount

$14

General + Research + Ownership

Payments

1

Total payment records

General Amount

$14

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-03-01

Latest reported date

Top Companies

Largest payers in this snapshot

CompanyAmount
Smith+Nephew, Inc.$14
View all Open Payments →|Open Payments Risk Radar →

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2012-10-18

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20121018000357INurse PractitionerPATBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 19146)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 9537552419View full group profile
NameSpecialtyState
Nurse PractitionerPA
Nurse PractitionerPA
Internal MedicinePA
Nurse PractitionerPA
Nurse PractitionerPA
Nurse PractitionerPA
Internal Medicine, Geriatric MedicinePA
Clinical Social WorkerPA
Nurse PractitionerPA
General PracticePA

Reviews

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Frequently asked questions

What number should I use to identify DOREEN KAY PUPO (CRNP) for billing?
Administrative and clinical systems typically use NPI 1194086868 for DOREEN KAY PUPO (CRNP).
Quick check: is DOREEN KAY PUPO (CRNP) active?
Public NPPES data shows DOREEN KAY PUPO (CRNP) with an active NPI status right now.
How should patients interpret DOREEN KAY PUPO (CRNP)'s specialty?
The extract shows Nurse Practitioner for DOREEN KAY PUPO (CRNP). Clinical services aligned with this taxonomy classification.
Can patients visit DOREEN KAY PUPO (CRNP) in Philadelphia, Pennsylvania?
For routing, start with Philadelphia, Pennsylvania for DOREEN KAY PUPO (CRNP), then verify phone and hours locally.
Can I verify credentials using only NPI?
NPI confirms identity in the directory; licensure and board certification require separate checks.

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