Individual provider Active NPI

Rahul Gupta, MD

  • Emergency Medicine Physician
  • Saint Louis, MO
National Provider Identifier
1013594803
Registry record updated Oct 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
2024007334 Issued in MO
Practice address
10010 Kennerly Rd
Saint Louis, MO 63128-2106
Phone
(314) 525-1906
NPI assigned
Mar 26, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 9, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 036168618 IL
Emergency Medicine Physician 207P00000X 2024007334 MO Primary

Addresses

Primary practice location

10010 Kennerly Rd
Saint Louis, MO 63128-2106

Mailing address

10010 Kennerly Rd
Saint Louis, MO 63128-2106
Phone (314) 525-1906

Other practice location 1

615 S New Ballas Rd
Saint Louis, MO 63141-8221
Phone (314) 251-6090

Other practice location 2

901 E 5th St
Washington, MO 63090-3127
Phone (636) 239-8011

Other practice location 3

1400 US Highway 61
Festus, MO 63028-4100
Phone (636) 933-1111

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO, IL2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20240805001630 MO Practitioner - Emergency Medicine 1153868443 Reassigns benefits to 4 organizations
I20241021001472 IL Practitioner - Emergency Medicine 1153868443 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Pennsylvania State University College of Medicine, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cepamerica Illinois LLPGroup PAC ID 3274793633, 492 clinicians
Mercy Hospital SouthGroup PAC ID 8426962556, 45 clinicians

Practice addresses (Care Compare)

1 Saint Elizabeth Blvd
O Fallon, IL 62269-1099
Phone (618) 234-2120

10010 Kennerly Rd
Saint Louis, MO 63128-2106
Phone (314) 525-1906

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2024007334MOMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
St Louis Pathology Assoc Inc. Current Accepting new patients
Mercy Hospitals East Communities CurrentSince Jul 15, 2024 Accepting new patients
Mercy Hospitals East Communities Emergency Medicine CurrentSince Jul 15, 2024 Accepting new patients
Mercy Hospitals East Communities CurrentSince Jul 15, 2024 Accepting new patients
Cepamerica Illinois LLP Emergency Medicine CurrentSince Oct 1, 2024 Accepting new patients
Cepamerica Illinois LLP Emergency Medicine Current Accepting new patients
Mercy Hospital South CurrentSince Jul 15, 2024 Accepting new patients
Cepamerica Illinois LLP Emergency Medicine CurrentSince Oct 1, 2024 Accepting new patients
Mercy Hospital Jefferson CurrentSince Jul 15, 2024 Accepting new patients
Mercy Hospital South Emergency Medicine CurrentSince Jul 15, 2024 Accepting new patients
Mercy Hospitals East Communities Emergency Medicine CurrentSince Jul 15, 2024 Accepting new patients
Mercy Hospital Jefferson CurrentSince Jul 15, 2024 Accepting new patients

Locations

2100 Powell St
Ste 400
Emeryville, CA 94608
Phone (510) 350-2638

1601 Cummins Dr
Ste D
Modesto, CA 95358
Phone (510) 851-7423

1 Saint Elizabeth Blvd
O Fallon, IL 62269
Phone 618234212012438

4500 Memorial Dr
Swansea, IL 62226
Phone (618) 233-7750

1400 US Highway 61
Crystal Cty, MO 63028
Phone (636) 933-1111

615 S New Ballas Rd
Saint Louis, MO 63141
Phone (314) 251-4687

10010 Kennerly Rd
Saint Louis, MO 63128
Phone (314) 525-1328

901 E 5th St
Washington, MO 63090
Phone (636) 239-8000

Organizations & group practices 12

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 6

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": "1616716800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728432000000",
    "number": "1013594803",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10010 KENNERLY RD",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631282106",
            "telephone_number": "314-525-1906"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10010 KENNERLY RD",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631282106",
            "telephone_number": "314-525-1906"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "615 S New Ballas Rd",
            "address_purpose": "LOCATION",
            "city": "Saint Louis",
            "state": "MO",
            "postal_code": "631418221",
            "country_code": "US",
            "telephone_number": "314-251-6090",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "901 E 5th St",
            "address_purpose": "LOCATION",
            "city": "Washington",
            "state": "MO",
            "postal_code": "630903127",
            "country_code": "US",
            "telephone_number": "636-239-8011",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1400 US Highway 61",
            "address_purpose": "LOCATION",
            "city": "Festus",
            "state": "MO",
            "postal_code": "630284100",
            "country_code": "US",
            "telephone_number": "636-933-1111",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GUPTA",
        "first_name": "RAHUL",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-03-26",
        "last_updated": "2024-10-09",
        "certification_date": "2024-10-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "IL",
            "license": "036168618",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "MO",
            "license": "2024007334",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Louis, MO

Sources for this page

Verify at the official NPI Registry.