SUSAN KUPSTAS CRNP
NPI 1104710581
Nurse Practitioner - Family in Wilkes Barre, PA

Q: What is Susan Kupstas's NPI number?

The NPI number for Susan Kupstas is 1104710581. It was assigned to this individual provider in the NPPES registry on June 9, 2025.

Q: What is Susan Kupstas's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

Q: When was this NPI record last updated?

The NPPES record for Susan Kupstas was last updated on July 31, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since June 09, 2025PECOS Enrolled

169 N PENNSYLVANIA AVE, WILKES BARRE, PA 18701(570) 491-0126(570) 230-0013 Get Directions Write a Review

NPPES record last updated: July 31, 2025. Verified against the NPPES registry weekly; last sync: August 09, 2026.

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About Susan Kupstas Crnp NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

SUSAN KUPSTAS CRNP (NPI 1104710581) is an individual family provider in Wilkes Barre, Pennsylvania, licensed in Pennsylvania (SP033418) and active in the NPI registry since June 2025. She is enrolled in Medicare PECOS and is a graduate of Other (2025).

NPPES Registry Identity

NPI1104710581

Entity TypeIndividualFemale

Primary Taxonomy363LF0000X

Provider Legal NameSUSAN KUPSTASCredential: CRNP

Location Address169 N PENNSYLVANIA AVEWilkes Barre, PA 18701-3603

Mailing Address298 Ridge StHanover Township, PA 18706-3037 · (570) 709-9353

Phone(570) 491-0126

Fax(570) 230-0013

Sole ProprietorNo

Medical School CMSOtherGraduated 2025

Enumeration DateJune 9, 2025

Last NPPES UpdateJuly 31, 2025

NPPES CertifiedJuly 31, 2025

✔ NPI 1104710581 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363LF0000X

License✔ Licensed in PA · SP033418

Also ListedRegistered NurseTaxonomy 163W00000X · License RN631817 (PA)

169 N PENNSYLVANIA AVE, Wilkes Barre, PA 18701

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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Susan Kupstas Crnp is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID2365941655

PECOS Enrollment IDI20250814002913

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 18701 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$84.88 typical visit price

range $54.64 – $166.87

Typical copayment $21.22 (range $13.66 – $41.71)

Most-billed visit code 99203

Established Patient

$96.82 typical visit price

range $17.33 – $135.84

Typical copayment $24.20 (range $4.33 – $33.96)

Most-billed visit code 99214

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 18

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

NINA M POLIAK M.D.

Pediatrics