ROBERT SHUPAK, M.D. — NPI 1619974110 (Board-Certified Anesthesiologist & Interventional Pain Specialist in SPRINGERVILLE, AZ)

CMS-1500 Box 24J / 33a • NPI

1619974110

Type 1 Individual Rendering/Ordering

HIPAA NUCC Taxonomy • CMS Code

207L00000X (CMS 05)

Board-Certified Anesthesiologist & Interventional Pain Specialist

Box 32 Service Location & ZIP+4

118 S MOUNTAIN AVE, SPRINGERVILLE, AZ, 85938-5104

✓ 9-Digit EDI 837 ZIP+4 (85938-5104)

Practice Phone & Referral Fax

(602) 273-6770

Fax: (602) 889-0489

✓ HHS OIG LEIE Sanction Screening — VERIFIED CLEAR: NPI 1619974110 (ROBERT SHUPAK, M.D.) has 0 active federal exclusions across all 84,224 HHS OIG LEIE sanction records (Database Verified: 2026-11-11).

CMS Medicare Order & Referring PECOS Eligibility

This practitioner does not currently appear in the CMS individual Order & Referring PECOS file (may practice in pediatrics, commercial-only networks, or hospital-employed settings).

Official CMS NPPES Credential & Practice Profile

10-Digit NPI Number	`1619974110` (NPI-1 Individual Practitioner)
Provider / Legal Name	ROBERT SHUPAK, M.D.
Plain-English Specialty	Board-Certified Anesthesiologist & Interventional Pain Specialist NUCC Code: `207L00000X` (Anesthesiology)
Certifying / Licensing Body	American Board of Anesthesiology (ABA)
Practice Location Address	118 S MOUNTAIN AVE, SPRINGERVILLE, AZ, 85938-5104
Practice Telephone / Fax	Tel: (602) 273-6770 \| Fax: (602) 889-0489
Administrative Mailing Address	PO BOX 29211, PHOENIX, AZ, 85038-9211
Enumeration & Last Sync	Enumerated: 2005-06-30 \| CMS Record Updated: 2026-07-13

Clinic Location, Accessibility & Directions

📍 Practice Location & Patient Access

118 S MOUNTAIN AVE, SPRINGERVILLE, AZ, 85938-5104

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Plain-English Taxonomy & CMS Crosswalk (207L00000X)

What Does Taxonomy Code 207L00000X Mean?

In the HIPAA National Uniform Claim Committee (NUCC) classification, code 207L00000X translates to:
"Board-Certified Anesthesiologist & Interventional Pain Specialist"

CMS-1500 Medicare Specialty Crosswalk: CMS Code 05 (Physician/Anesthesiology) • CMS Code 79 (Physician/Addiction Medicine)
Certifying / Accrediting Authority: American Board of Anesthesiology (ABA)
Clinical Scope: Pre-surgical anesthesia evaluation, obstetric labor epidural care, or interventional spine and nerve block procedures for chronic pain.

Specialty Clinical Procedures & Therapeutic Classes

Standard Scope of Care (ROBERT SHUPAK, M.D.)

Typical CPT / Diagnostic Procedures:

General Endotracheal Anesthesia & Total Intravenous Anesthesia (TIVA)
Ultrasound-Guided Peripheral Nerve Blocks & Labor Epidural Analgesia
Fluoroscopic Epidural Steroid Injections & Facet Joint Blocks

Common Therapeutic Classes:

Propofol, Sevoflurane, Rocuronium & Sugammadex
Bupivacaine, Lidocaine & Ropivacaine Regional Anesthetics

All Registered NUCC Taxonomies & State Licenses

Taxonomy Code & Plain-English Description	State License & Primary Status
`207L00000X` — Anesthesiology Plain English: Board-Certified Anesthesiologist & Interventional Pain Specialist	State: AZ \| License: `18763` \| Primary: Yes (Primary)

Medical Billing, RCM & Hospital Credentialing Teams:

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ROBERT SHUPAK, M.D. (NPI #1619974110)