MEDICARE: KS MD INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QM0850X	Adult Mental Health Clinic/Center

General Provider Information

NPI Number	:	1730786203
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	KS MD INC

Provider Business Mailing Address
First Line	:	13 SUMMIT SQUARE CTR UNIT 303
Second Line	:
City	:	LANGHORNE
State	:	PA
Zip	:	19047-1078
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1190 OLD YORK RD STE A&B
Second Line	:
City	:	WARMINSTER
State	:	PA
Zip	:	18974-2047
Country	:	US
Telephone Number	:	215-491-9900
Fax Number	:	215-491-9902

Authorized Official
Title or Position	:	OWNER/PHYSICIAN
Name	:	KATRINA SHCHUPAK
Credential	:	MD
Telephone Number	:	347-285-6188

Provider Enumeration Date	:	10/07/2020
Last Update Date	:	10/15/2025

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