Krishanu Bappa Gupta, M.D., PH.D.

Primary specialty

Diagnostic Radiology PhysicianTaxonomy code 2085R0202X

License

MD11080 Issued in RI

Practice address

525 Broad St
Suite 202
Cumberland, RI 02864-6919

Phone

(401) 727-4600

Fax

(401) 727-4690

NPI assigned

Nov 4, 2005

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in RI

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Diagnostic Radiology

Education

Perelman School of Med at the University of Pennsylvania, 1997

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Advanced Radiology, Inc.Group PAC ID 9234140690, 3 clinicians

Open MRI of New England, Inc.Group PAC ID 7012928294, 3 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

75 of 100Reported as group

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine, Doctor of Philosophy

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Advanced Radiology, Inc.

  • Diagnostic Radiology Physician
  • Cumberland, RI
  • NPI 1780638494
  Medicare reassignment Care Compare group NPD
• Open MRI of New England, Inc.

  • Diagnostic Radiology Physician
  • Cumberland, RI
  • NPI 1053365734
  Medicare reassignment Care Compare group NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1131062400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1323129600000",
    "number": "1003807397",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "525 BROAD ST",
            "address_2": "SUITE 202",
            "city": "CUMBERLAND",
            "state": "RI",
            "postal_code": "028646919",
            "telephone_number": "401-727-4600",
            "fax_number": "401-727-4690"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "525 BROAD ST",
            "address_2": "SUITE 202",
            "city": "CUMBERLAND",
            "state": "RI",
            "postal_code": "028646919",
            "telephone_number": "401-727-4600",
            "fax_number": "401-727-4690"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUPTA",
        "first_name": "KRISHANU",
        "middle_name": "BAPPA",
        "credential": "M.D., PH.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-04",
        "last_updated": "2011-12-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "RI",
            "license": "MD11080",
            "primary": true
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "MA",
            "license": "210605",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7010331",
            "state": "RI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS - RI",
            "identifier": "21093-9",
            "state": "RI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE",
            "identifier": "16-00084",
            "state": "RI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Greater Providence Chapter,Riarc
• Kristin A Grimes, MD
• Lindsey Grissom
• Amanda Elizabeth Guerra
• Carrie L Guerra, PT, DPT
• Rajeev K Gupta, MD
• Emma Katherine Guzman, MA
• Erik R Hamel, PHARMD
• Neenoofar Haneef, MD
• Sandra Janet Hanson

• Diagnostic Radiology Physician in Cumberland, RI
• Providers in Cumberland, RI by specialty
• Diagnostic Radiology Physician in Rhode Island

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 6, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.