Individual provider Active NPI

Nitin Gupta, M.D.

  • Gastroenterology Physician
  • Atlanta, GA
National Provider Identifier
1013113364
Registry record updated Oct 3, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
078939 Issued in GA
Practice address
980 Johnson Fy Rd NE Ste 820
Atlanta, GA 30342-1608
Phone
(404) 252-9307
Fax
(404) 252-5839
NPI assigned
Jun 25, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 3, 2018

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 22586 MS
Gastroenterology Physician 207RG0100X 249386 MA
Gastroenterology Physician 207RG0100X 22586 MS
Gastroenterology Physician 207RG0100X 078939 GA Primary

Addresses

Primary practice location

980 Johnson Fy Rd NE Ste 820
Atlanta, GA 30342-1608

Mailing address

1001 Summit Blvd Ste B
Brookhaven, GA 30319-6408
Phone (770) 989-1668

Other identifiers 3

IdentifierTypeStateIssuer
02959257MedicaidMS
P01402449OtherMSRR MEDICARE
003203822AMedicaidGA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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

Enrollment IDStateProvider typePAC IDDetails
I20180901000080 GA Practitioner - GastroenterologyPractitioner - Internal Medicine 6608043674 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
GastroenterologyAlso: Internal Medicine
Education
Vanderbilt University School of Medicine, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Aga, LLCGroup PAC ID 2365431350, 138 clinicians
Aga Professional Services LLCGroup PAC ID 3870768997, 175 clinicians

Practice addresses (Care Compare)

980 Johnson Ferry Rd
Suite 820
Atlanta, GA 30342-1608
Phone (404) 252-9307

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
74.39 of 100Reported as group
Quality
44.91
Promoting interoperability
98
Improvement activities
40
Cost
71.38

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy91
Upper gastrointestinal (GI) endoscopy for acid reflux84

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
078939GAMDGastroenterology Physician
249386MAMDGastroenterology Physician
22586MSMDGastroenterology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Aga, LLC Gastroenterology CurrentSince Apr 1, 2018 Accepting new patients
Aga Professional Services, LLC Gastroenterology CurrentSince Apr 1, 2018 Accepting new patients

Locations

2520 Windy Hill Rd SE
Ste 102
Marietta, GA 30067
Phone (770) 612-8165

488 Kennesaw Ave NW
Ste 150
Marietta, GA 30060
Phone (770) 427-3075

488 Kennesaw Ave NW
Ste 200
Marietta, GA 30060
Phone (770) 427-3075

980 Johnson Fy Rd NE
Ste 820
Sandy Springs, GA 30342
Phone (404) 252-9307

5671 Peachtree Dunwoody Rd
Ste 600
Sandy Springs, GA 30342
Phone (404) 252-9307

5671 Peachtree Dunwoody Rd
Ste 511
Sandy Springs, GA 30342

4275 Johns Creek Pkwy
Ste A
Suwanee, GA 30024
Phone (678) 475-1606

Networks

  • FL HMO
  • TN PPO C-SNP
  • AL HMO
  • AL HMO D-SNP
  • FL HMO C-SNP
  • devoted network organization-25ba88d3-d0a6-4213-84f1-eef6f2b59f68
  • FL HMO D-SNP
  • devoted network organization-14bfd35d-d818-4696-813b-340339e464ef
  • devoted network organization-d5084670-562f-408b-b100-22a1a4ef4d82
  • TN PPO

Interoperability endpoints

  • Direct secure messaging: nitin.gupta@ud.eclinicaldirectplus.com
  • FHIR API: https://fhir-myrecord.cerner.com/r4/d88010de-d791-42d4-b72d-513f9afc5ed1/

Organizations & group practices 2

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1182729600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1538524800000",
    "number": "1013113364",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1001 SUMMIT BLVD STE B",
            "city": "BROOKHAVEN",
            "state": "GA",
            "postal_code": "303196408",
            "telephone_number": "770-989-1668",
            "fax_number": "678-388-1759"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "980 JOHNSON FY RD NE STE 820",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303421608",
            "telephone_number": "404-252-9307",
            "fax_number": "404-252-5839"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUPTA",
        "first_name": "NITIN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-06-25",
        "last_updated": "2018-10-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MS",
            "license": "22586",
            "primary": false
        },
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "MA",
            "license": "249386",
            "primary": false
        },
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "MS",
            "license": "22586",
            "primary": false
        },
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "GA",
            "license": "078939",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02959257",
            "state": "MS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "P01402449",
            "state": "MS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003203822A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

Verify at the official NPI Registry.