Individual provider Active NPI

Nikhil R Gupta, MD

  • Public Health & General Preventive Medicine Physician
  • Lantana, FL
National Provider Identifier
1033670237
Registry record updated Sep 6, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Public Health & General Preventive Medicine PhysicianTaxonomy code 2083P0901X
License
1033670237 Issued in FL
Practice address
1250 Southwinds Dr
Lantana, FL 33462-1459
Phone
(561) 547-6800
Fax
(561) 547-6865
NPI assigned
Mar 29, 2019
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 6, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Public Health & General Preventive Medicine Physician 2083P0901X TRN32423 FL
Student in an Organized Health Care Education/Training Program 390200000X
Public Health & General Preventive Medicine Physician 2083P0901X 1033670237 FL Primary

Addresses

Primary practice location

1250 Southwinds Dr
Lantana, FL 33462-1459

Mailing address

800 Clematis St Ste 5-531
West Palm Beach, FL 33401-5107
Phone (561) 671-4036

Other practice location 1

1601 Owen Dr
Fayetteville, NC 28304-3425
Phone (910) 678-0100

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20231011002415 FL Practitioner - Preventive Medicine 3577896497

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1033670237FLMDPublic Health & General Preventive Medicine Physician
TRN32423FLMDPublic Health & General Preventive Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Florida Department of Health CurrentSince Sep 18, 2023 Accepting new patients
Florida Department of Health CurrentSince Sep 18, 2023 Accepting new patients

Locations

1250 Southwinds Dr
Lantana, FL 33462
Phone (561) 547-6800

800 Clematis St
West Palm Beach, FL 33401
Phone (561) 837-5560

800 Clematis St
Ste 5531
West Palm Beach, FL 33401
Phone (561) 671-4036

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/JADFAD/Endpoint/JADFAD

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": "1553817600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1693958400000",
    "number": "1033670237",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 CLEMATIS ST STE 5-531",
            "city": "WEST PALM BEACH",
            "state": "FL",
            "postal_code": "334015107",
            "telephone_number": "561-671-4036"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1250 SOUTHWINDS DR",
            "city": "LANTANA",
            "state": "FL",
            "postal_code": "334621459",
            "telephone_number": "561-547-6800",
            "fax_number": "561-547-6865"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1601 Owen Dr",
            "address_purpose": "LOCATION",
            "city": "Fayetteville",
            "state": "NC",
            "postal_code": "283043425",
            "country_code": "US",
            "telephone_number": "910-678-0100",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GUPTA",
        "first_name": "NIKHIL",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-03-29",
        "last_updated": "2023-09-06",
        "certification_date": "2023-09-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2083P0901X",
            "taxonomy_group": "",
            "desc": "Preventive Medicine, Public Health & General Preventive Medicine",
            "state": "FL",
            "license": "TRN32423",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2083P0901X",
            "taxonomy_group": "",
            "desc": "Preventive Medicine, Public Health & General Preventive Medicine",
            "state": "FL",
            "license": "1033670237",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lantana, FL

Sources for this page

Verify at the official NPI Registry.