Individual provider Active NPI

Jonathan Gupta, M.D.

  • Diagnostic Radiology Physician
  • Pontiac, MI
National Provider Identifier
1033407499
Registry record updated Aug 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
4301099446 Issued in MI
Practice address
44405 Woodward Ave
Pontiac, MI 48341-5023
Phone
(248) 858-3000
NPI assigned
Jul 19, 2011
Last updated
Aug 26, 2024By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 26, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 331821 NY
Diagnostic Radiology Physician 2085R0202X 4301099446 MI Primary
General Practice Physician 208D00000X 4301099446 MI

Addresses

Primary practice location

44405 Woodward Ave
Pontiac, MI 48341-5023

Mailing address

32640 Whatley Rd
Franklin, MI 48025-1123
Phone (248) 390-0579

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI, NY, OH3 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 3

Enrollment IDStateProvider typePAC IDDetails
I20170221000523 MI Practitioner - Diagnostic RadiologyPractitioner - Interventional Radiology 2860776762 Reassigns benefits to 6 organizations
I20240911003417 NY Practitioner - Diagnostic Radiology 2860776762 Reassigns benefits to 4 organizations
I20240925000389 OH Practitioner - Diagnostic Radiology 2860776762 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Radiology Muskegon, PCGroup PAC ID 1355241191, 22 clinicians

Practice addresses (Care Compare)

Franklin, MI 48025
Phone (231) 722-6005

32 -36 Harrison St
Johnson City, NY 13790-2122
Phone (607) 729-1999

32640 Whatley Rd
Franklin, MI 48025-1123
Phone (607) 729-1999

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
331821NYMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Proscan Womens Imaging at Redbank Diagnostic Radiology CurrentSince Aug 7, 2024 Accepting new patients
Dublin Diagnostic Imaging LLC Diagnostic Radiology CurrentSince Aug 6, 2024 Accepting new patients
Henry Ford Health System Current Accepting new patients
Delaware Valley Hospital, Inc CurrentSince Mar 22, 2025 Accepting new patients
Beacon Dowagiac Inc CurrentSince Oct 1, 2022 Accepting new patients
Chenango Memorial Hospital, Inc CurrentSince Sep 14, 2024 Accepting new patients
Beacon Kalamazoo Inc CurrentSince Oct 15, 2022 Accepting new patients
Delaware Valley Hospital, Inc CurrentSince Aug 23, 2025 Accepting new patients
Chenango Memorial Hospital Inc CurrentSince Sep 14, 2024 Accepting new patients
Beacon Dowagiac Inc Diagnostic Radiology CurrentSince Oct 1, 2022 Accepting new patients
CT at Midtown Diagnostic Radiology CurrentSince Aug 7, 2024 Accepting new patients
Henry Ford Health System Diagnostic Radiology CurrentSince Feb 1, 2017 Accepting new patients
Beacon Kalamazoo Inc Diagnostic Radiology CurrentSince Oct 15, 2022 Accepting new patients
Eastpointe Radiologists, PC Diagnostic Radiology CurrentSince Apr 21, 2024 Accepting new patients
Beacon Kalamazoo Inc Current Accepting new patients
Marwan Shuayto MD PC Diagnostic Radiology CurrentSince Aug 11, 2019 Accepting new patients
Proscan Radiology, LLC Diagnostic Radiology CurrentSince Aug 7, 2024 Accepting new patients
Proscan Imaging of Pickerington, LLC Diagnostic Radiology CurrentSince Aug 6, 2024 Accepting new patients
Chenango Memorial Hospital Inc Current Accepting new patients
Proscan Womens Imaging at Redbank LLC Diagnostic Radiology CurrentSince Aug 7, 2024 Accepting new patients
Radiology Muskegon PC Diagnostic Radiology CurrentSince Oct 1, 2024 Accepting new patients
Henry Ford Health System CurrentSince Feb 1, 2017 Accepting new patients
United Health Services Hospitals, Inc. CurrentSince Aug 16, 2024 Accepting new patients
Chenango Memorial Hospital, Inc. Past Accepting new patients
Delaware Valley Hospital, Inc Past Accepting new patients
Spartan Radiology, Inc Diagnostic Radiology PastSince Jan 1, 2020 Accepting new patients

Locations (25 of 34)

3035 Capital Ave SW
Battle Creek, MI 49015
Phone (269) 565-9100

51307 Gratiot Ave
Chesterfield, MI 48051
Phone (586) 741-3772

11320 S M 43 Hwy
Delton, MI 49046
Phone (269) 623-5521

22101 Moross Rd
Detroit, MI 48236
Phone (313) 343-3248

2799 W Grand Blvd
Detroit, MI 48202
Phone (313) 876-2062

420 W High St
Dowagiac, MI 49047
Phone (269) 782-8681

21003 Mack Ave
Grosse Pointe Woods, MI 48236
Phone (313) 881-0411

1521 Gull Rd
Kalamazoo, MI 49048
Phone (269) 226-5165

1535 Gull Rd
Ste 200
Kalamazoo, MI 49048
Phone (269) 388-6350

1541 Gull Rd
Ste 100
Kalamazoo, MI 49048
Phone (269) 226-5290

1700 Gull Rd
Kalamazoo, MI 49048
Phone (269) 342-1099

1701 Gull Rd
Kalamazoo, MI 49048
Phone (269) 226-2550

200 N Park St
Kalamazoo, MI 49007
Phone (269) 373-7453

3025 Gull Rd
Kalamazoo, MI 49048
Phone (269) 343-1264

6565 W Main St
Ste 135
Kalamazoo, MI 49009
Phone (269) 372-7459

1700 Clinton St
Muskegon, MI 49442
Phone (231) 726-3511

411 Naomi St
Plainwell, MI 49080
Phone (269) 685-0700

44405 Woodward Ave
Pontiac, MI 48341
Phone (248) 858-3000

1201 Stone St
Ste 8
Port Huron, MI 48060
Phone (810) 985-4411

615 Pine St
Port Huron, MI 48060
Phone (810) 989-0000

7901 Angling Rd
Portage, MI 49024
Phone (269) 324-8405

8450 N 32nd St
Richland, MI 49083
Phone (269) 226-2500

72 S State St
Shelby, MI 49455
Phone (231) 728-4601

1241 W Broadway St
Three Rivers, MI 49093
Phone (269) 273-9539

701 S Health Parkway
Three Rivers, MI 49093
Phone (269) 273-9691

Organizations & group practices 26

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.

View all 26

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": "1311033600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724630400000",
    "number": "1033407499",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "32640 WHATLEY RD",
            "city": "FRANKLIN",
            "state": "MI",
            "postal_code": "480251123",
            "telephone_number": "248-390-0579"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "44405 WOODWARD AVE",
            "city": "PONTIAC",
            "state": "MI",
            "postal_code": "483415023",
            "telephone_number": "248-858-3000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUPTA",
        "first_name": "JONATHAN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-07-19",
        "last_updated": "2024-08-26",
        "certification_date": "2024-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "NY",
            "license": "331821",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "MI",
            "license": "4301099446",
            "primary": true
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "MI",
            "license": "4301099446",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pontiac, MI

Sources for this page

Verify at the official NPI Registry.