Individual provider Active NPI

Gayatri Gupta, MD

  • Internal Medicine Physician
  • Chappaqua, NY
National Provider Identifier
1023192077
Registry record updated May 14, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
252346 Issued in NY
Practice address
11 Crystal Spring Rd
Chappaqua, NY 10514-1412
Phone
(914) 438-2703
NPI assigned
Oct 25, 2006
Last updated
May 14, 2009By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 14, 2009

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Geriatric Medicine (Internal Medicine) Physician 207RG0300X 252346 NY
Internal Medicine Physician 207R00000X 252346 NY Primary

Addresses

Primary practice location

11 Crystal Spring Rd
Chappaqua, NY 10514-1412

Mailing address

845 Palmer Ave
Mamaroneck, NY 10543-2406
Phone (914) 864-5672

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20060117000922 NY Practitioner - Internal MedicinePractitioner - Geriatric Medicine 9638193618 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
001180NYMDOccupational Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Gayatri Gupta Physician PLLC Internal Medicine CurrentSince Oct 1, 1984 Accepting new patients
Westchester County Health Care Corporation Past Accepting new patients
Jewish Home Lifecare Sarah Neuman Center Westchester Past Accepting new patients
Palmer Avenue SNF Operations LLC Past Accepting new patients

Locations

845 Palmer Ave
Mamaroneck, NY 10543
Phone (914) 357-0795

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Sarah Neuman Center for Rehabilitation and NursingMamaroneck, NY, CCN 335296001 Skilled nursing facility Operational/Managerial Control
Adp of the SNF
Aug 4, 2025
Aug 4, 2025

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 4

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

NPI Registry JSON

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

{
    "created_epoch": "1161734400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1242259200000",
    "number": "1023192077",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "845 PALMER AVE",
            "city": "MAMARONECK",
            "state": "NY",
            "postal_code": "105432406",
            "telephone_number": "914-864-5672"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11 CRYSTAL SPRING RD",
            "city": "CHAPPAQUA",
            "state": "NY",
            "postal_code": "105141412",
            "telephone_number": "914-438-2703"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUPTA",
        "first_name": "GAYATRI",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-10-25",
        "last_updated": "2009-05-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Geriatric Medicine",
            "state": "NY",
            "license": "252346",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "252346",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chappaqua, NY

Sources for this page

Verify at the official NPI Registry.