Individual provider Active NPI

Shivali Gupta, DO, MPH

  • Orthopaedic Surgery Physician
  • San Jose, CA
National Provider Identifier
1023509502
Registry record updated May 26, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
License
OP61408334 Issued in WA
Practice address
1604 Blossom Hill Rd Ste 10
San Jose, CA 95124-6350
Phone
(408) 528-8833
NPI assigned
May 21, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 26, 2026

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Foot and Ankle Surgery Physician 207XX0004X 20A24271 CA
Orthopaedic Surgery Physician 207X00000X 20A24271 CA
Orthopaedic Surgery Physician 207X00000X OP61408334 WA Primary
Orthopaedic Foot and Ankle Surgery Physician 207XX0004X OP61408334 WA

Addresses

Primary practice location

1604 Blossom Hill Rd Ste 10
San Jose, CA 95124-6350

Mailing address

1604 Blossom Hill Rd Ste 10
San Jose, CA 95124-6350

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA, CA2 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
I20230807002551 WA Practitioner - Orthopedic Surgery 6103224035 Reassigns benefits to 1 organization
I20260409001979 CA Practitioner - Orthopedic Surgery 6103224035 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Orthopedic Surgery
Education
Rocky Vista University College of Osteopathic Med, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
James Petros MD IncGroup PAC ID 0941479216, 21 clinicians

Practice addresses (Care Compare)

1604 Blossom Hill Rd
Suite 10
San Jose, CA 95124-6350
Phone (408) 528-8833

Merit-based Incentive Payment System (MIPS)

Final score
93.85 of 100Reported as apm
Quality
74.6
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
20A24271CAMDOrthopaedic Surgery Physician
OP61408334WAMDOrthopaedic Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
The Association of University Physicians Orthopaedic Surgery CurrentSince Jun 5, 2023 Accepting new patients

Locations

1959 NE Pacific St
Seattle, WA 98195
Phone (206) 598-4333

325 9th Ave
Seattle, WA 98104
Phone (206) 731-3000

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.

NPI Registry JSON

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

{
    "created_epoch": "1526860800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1779753600000",
    "number": "1023509502",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1604 BLOSSOM HILL RD STE 10",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951246350"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1604 BLOSSOM HILL RD STE 10",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951246350",
            "telephone_number": "408-528-8833"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUPTA",
        "first_name": "SHIVALI",
        "name_prefix": "Dr.",
        "credential": "DO, MPH",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-05-21",
        "last_updated": "2026-05-26",
        "certification_date": "2026-05-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207XX0004X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Foot and Ankle Surgery",
            "state": "CA",
            "license": "20A24271",
            "primary": false
        },
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "CA",
            "license": "20A24271",
            "primary": false
        },
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "WA",
            "license": "OP61408334",
            "primary": true
        },
        {
            "code": "207XX0004X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Foot and Ankle Surgery",
            "state": "WA",
            "license": "OP61408334",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Jose, CA

Sources for this page

Verify at the official NPI Registry.