Active NPI
Pankaj Gupta, MD, MBA
- Geriatric Medicine (Internal Medicine) Physician
- Edison, NJ
National Provider Identifier
1013369461
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Geriatric Medicine (Internal Medicine) Physician
- License
- 237957-1
- Practice address
- 31 Southfield Rd
Edison, NJ 08820-3141 - Phone
- (860) 989-8829
- NPI assigned
- Jul 11, 2016
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Geriatric Medicine (Internal Medicine) Physician | 207RG0300X | 237957-1 | NY | Primary |
Addresses
Primary practice location
31 Southfield Rd
Edison, NJ 08820-3141
Mailing address
31 Southfield Rd
Edison, NJ 08820-3141
Phone (860) 989-8829
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Master of Business Administration, Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 237957-1 | NY | MD | Geriatric Medicine (Internal Medicine) Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1468195200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1468195200000",
"number": "1013369461",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "31 SOUTHFIELD RD",
"city": "EDISON",
"state": "NJ",
"postal_code": "088203141",
"telephone_number": "860-989-8829"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "31 SOUTHFIELD RD",
"city": "EDISON",
"state": "NJ",
"postal_code": "088203141",
"telephone_number": "860-989-8829"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GUPTA",
"first_name": "PANKAJ",
"name_prefix": "Dr.",
"credential": "MD, MBA",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2016-07-11",
"last_updated": "2016-07-11",
"status": "A"
},
"taxonomies": [
{
"code": "207RG0300X",
"taxonomy_group": "",
"desc": "Internal Medicine, Geriatric Medicine",
"state": "NY",
"license": "237957-1",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Edison, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 11, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.