1. Home
  2. Directory
  3. Texas
  4. Fort Worth
  5. Dentist
  6. NPI Profile

DR. RAYMOND PATRICK SHUPAK DMD, MD
NPI 1962798462
Dentist - Oral and Maxillofacial Surgery in Fort Worth, TX

Active since June 22, 2011PECOS EnrolledAccepts Medicare Assignment
1500 SOUTH MAIN STREET JPS HOSPITAL, DEPT OF OMFS, FORT WORTH, TX 76104(817) 702-5595 Get Directions Write a Review

NPPES record last updated: May 24, 2021. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: May 24, 2021, Apr 1, 2021, Feb 20, 2019 and 1 more (4 updates tracked since 2018).

About Dr. Raymond Patrick Shupak Dmd, Md NPPES

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

DR. RAYMOND PATRICK SHUPAK DMD, MD (NPI 1962798462) is an individual oral and maxillofacial surgery provider in Fort Worth, Texas, licensed in Texas (35670) and active in the NPI registry since June 2011. He is enrolled in Medicare PECOS, is affiliated with Jps Health Network, and maintains 2 additional practice locations.

NPPES Registry Identity

NPI1962798462
Entity TypeIndividualMale
Primary Taxonomy1223S0112X
Provider Legal NameDR. RAYMOND PATRICK SHUPAKCredential: DMD, MD
Location Address1500 SOUTH MAIN STREET JPS HOSPITAL, DEPT OF OMFSFort Worth, TX 76104
Mailing Address1500 South Main Street Jps Hospital, Dept Of OmfsFort Worth, TX 76104 · (817) 702-5595
Phone(817) 702-5595
Sole ProprietorNo
Medical School CMSUniv Of Pennsylvania School Of Dental MedicineGraduated 2011
Enumeration DateJune 22, 2011
Last NPPES UpdateMay 24, 20214 updates tracked since enumeration
NPPES CertifiedMay 24, 2021
✔ NPI 1962798462 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyDentist · Oral and Maxillofacial SurgeryDental Providers
Taxonomy Code1223S0112X
Licenses✔ Licensed in TX · 35670✔ Licensed in PA · DS038719
Definition
An oral and maxillofacial surgery dentist specialized in the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region.
Also ListedOral & Maxillofacial SurgeryTaxonomy 204E00000X · License S4567 (TX), MD461668 (PA)
1500 SOUTH MAIN STREET JPS HOSPITAL, Fort Worth, TX 76104
Open in Google Maps ↗

Secondary Practice Locations 2

Location 13501 Terrace StPittsburgh, PA 15213-2523 · Phone (973) 534-3775
Location 23501 Terrace Street, Suite 3189Pittsburgh, PA 15261 · Phone (412) 648-9100 · Fax (412) 383-7862

Other Identifiers 1

Medicaid1029564820001PA

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include BEST Life, Blue Cross and Blue Shield of Montana, Blue Cross and Blue Shield of Oklahoma and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Dr. Raymond Patrick Shupak Dmd, Md is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID1759645427
PECOS Enrollment IDI20200610002876
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.

Medicare Billing Reassignments

2

Medicare enrollment records show Raymond Shupak reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Oral & Maxillofacial Network, P.L.L.C.
Same address
Oral and Maxillofacial Surgery
1500 S MAIN ST
Fort Worth, TX 76104
  • Reassigned Medicare billing, Texas enrollment
  • Medicare enrollment name: Oral & Maxillofacial Network PLLC
  • 11 clinicians in this Medicare group
NPI 1417170655 (817) 920-6936
Geisinger Clinic
1,197 mi
Internal Medicine
3228 COLD SPRINGS RD
Huntingdon, PA 16652
  • Reassigned Medicare billing, Pennsylvania enrollment
  • 4,429 clinicians in this Medicare group
NPI 1548599913 (570) 271-5555

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Areas of Expertise CMS Part B claims 6

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214
This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.
38 services22 patients
Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213
This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.
34 services23 patients
X-ray of lower jaws, upper jaws and teeth 70355
An X-ray of lower jaws, upper jaws, and teeth is a diagnostic procedure that uses radiation to create images of these areas. This helps in identifying issues like tooth decay, gum problems, or jawbone irregularities. It's a quick, painless process and crucial for maintaining oral health.
14 services14 patients
New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more 99203
This service involves an initial office or outpatient visit for a new patient. The healthcare professional will spend 30-44 minutes understanding your health history, current issues, and discussing possible treatment plans. It's a comprehensive evaluation to start your healthcare journey.
13 services13 patients
New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more 99204
This is a first-time office or outpatient visit lasting between 45-59 minutes. The healthcare provider evaluates your health, discusses your medical history, and may suggest further tests or treatments. It's an opportunity to ask questions and understand your health better.
13 services13 patients
New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more 99204
This is a first-time office or outpatient visit lasting between 45-59 minutes. The healthcare provider evaluates your health, discusses your medical history, and may suggest further tests or treatments. It's an opportunity to ask questions and understand your health better.
11 services11 patients

Hospital Affiliations CMS Care Compare

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Jps Health Network

Acute Care Hospitals · Fort Worth, TX
3/5 CMS rating
OwnershipGovernment - Hospital District or Authority
CMS Certification Number450039
Location1500 S Main StFort Worth, TX 76104 · Tarrant County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 76104 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
$87.20 typical visit price
range $56.47 – $171.07
Typical copayment $21.80 (range $14.11 – $42.76)
Most-billed visit code 99203
Established Patient
$70.45 typical visit price
range $18.18 – $139.68
Typical copayment $17.61 (range $4.54 – $34.92)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Raymond Shupak's NPI number?

The NPI number for Raymond Shupak is 1962798462. It was assigned to this individual provider in the NPPES registry on June 22, 2011.

Where is Raymond Shupak located?

Raymond Shupak practices at 1500 South Main Street Jps Hospital Dept Of Omfs, Fort Worth, TX 76104. The listed phone number is (817) 702-5595.

What is Raymond Shupak's specialty?

The primary specialty registered for this NPI is Dentist, specializing in Oral and Maxillofacial Surgery, with taxonomy code 1223S0112X.

Is Raymond Shupak enrolled in Medicare?

Yes. Raymond Shupak is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

Which organizations bill Medicare for Raymond Shupak's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Raymond Shupak reassigns Medicare benefits to 2 organizations: Oral & Maxillofacial Network, P.L.L.C. (Fort Worth, TX) and Geisinger Clinic (Huntingdon, PA). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Raymond Shupak's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Raymond Shupak accept?

Health plans from BEST Life, Blue Cross and Blue Shield of Montana, Blue Cross and Blue Shield of Oklahoma, Blue Cross and Blue Shield of Texas and Cigna Healthcare and 11 other insurers list Raymond Shupak as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

Is Raymond Shupak affiliated with any hospitals?

According to CMS data, Raymond Shupak is affiliated with Jps Health Network.

When was this NPI record last updated?

The NPPES record for Raymond Shupak was last updated on May 24, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years 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.