Individual provider Active NPI

Ajay Gupta, MD

  • Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
  • Ypsilanti, MI
National Provider Identifier
1043492341
Registry record updated Dec 30, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Thoracic Surgery (Cardiothoracic Vascular Surgery) PhysicianTaxonomy code 208G00000X
License
4301076275 Issued in MI
Practice address
5325 Elliott Dr
Suite Number 102
Ypsilanti, MI 48197-8633
Phone
(734) 712-5500
Fax
(734) 712-8209
NPI assigned
Nov 29, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 30, 2009

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician 208G00000X 4301076275 MI Primary

Addresses

Primary practice location

5325 Elliott Dr
Suite Number 102
Ypsilanti, MI 48197-8633

Mailing address

5325 Elliott Dr
Suite Number 102
Ypsilanti, MI 48197-8633
Phone (734) 712-5500

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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
I20081203000232 MI Practitioner - Thoracic Surgery 5496816944 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Thoracic Surgery
Education
Wayne State University School of Medicine, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Iha Health Services CorporationGroup PAC ID 2466351440, 1,149 clinicians

Practice addresses (Care Compare)

128 Van Buren St
Chelsea, MI 48118-1623
Phone (734) 475-8677

20555 Victor Pkwy
Livonia, MI 48152-7031

44428 Woodward Ave
Suite 102
Pontiac, MI 48341-5009
Phone (734) 712-8700

51341 W Huron River Dr
Trinity Health Iha Medical Group Primary Ca
Van Buren Township, MI 48111-2571
Phone (734) 997-0304

5301 E Huron River Dr
Ypsilanti, MI 48197-1051

5301 McAuley Dr
Ypsilanti, MI 48197-1051

5325 Elliott Dr
Ypsilanti, MI 48197-8633

Hospital & facility affiliations

  • Trinity Health at Home- Southeast Michigan Home health agency, Livonia, MI, CCN 237069
  • Elara Caring Home health agency, Jackson, MI, CCN 237274
  • Trinity Health Ann Arbor Hospital Hospital, Ann Arbor, MI, CCN 230156
  • Trinity Health Livingston Hospital Hospital, Howell, MI, CCN 230069
  • St Joe Mercy Hospital System Livonia Hospital, Livonia, MI, CCN 230002
  • Chelsea Hospital Hospital, Chelsea, MI, CCN 230259

Procedures performed for Medicare patients

ProcedureNumber of procedures
Coronary artery bypass graft (CABG)38
Upper gastrointestinal (GI) endoscopy for acid reflux1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4301076275MIMDThoracic Surgery (Cardiothoracic Vascular Surgery) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Iha Health Service Corporation CurrentSince May 30, 2013 Accepting new patients
Iha Health Services Corporation Current Accepting new patients
Iha Health Services Corporation Thoracic Surgery (Cardiothoracic Vascular Surgery) CurrentSince May 30, 2013 Accepting new patients
Iha Health Services Corporation Past Accepting new patients
Michigan Multispecialty Physicians, P.C. Thoracic Surgery (Cardiothoracic Vascular Surgery) Past Accepting new patients
St Joseph Mercy Hospital Past Accepting new patients

Locations

16507 Southfield Rd
Allen Park, MI 48101
Phone (313) 389-0648

24 Frank Lloyd Wright Dr
Ann Arbor, MI 48105
Phone (734) 930-7400

7575 Grand River Rd
Ste 202
Brighton, MI 48114
Phone (810) 844-7566

128 Van Buren St
Chelsea, MI 48118
Phone (734) 475-8677

44428 Woodward Ave
Ste 102
Pontiac, MI 48341
Phone (734) 712-8700

5325 Elliott Dr
Ste 102
Ypsilanti, MI 48197
Phone (734) 712-3888

5333 McAuley Dr
Rm 3001
Ypsilanti, MI 48197
Phone (734) 712-4120

Interoperability endpoints

  • Direct secure messaging: agupta22186@direct.trinity-health.org

Organizations & group practices 6

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": "1196294400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1262131200000",
    "number": "1043492341",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5325 ELLIOTT DR",
            "address_2": "SUITE NUMBER 102",
            "city": "YPSILANTI",
            "state": "MI",
            "postal_code": "481978633",
            "telephone_number": "734-712-5500",
            "fax_number": "734-712-8209"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5325 ELLIOTT DR",
            "address_2": "SUITE NUMBER 102",
            "city": "YPSILANTI",
            "state": "MI",
            "postal_code": "481978633",
            "telephone_number": "734-712-5500",
            "fax_number": "734-712-8209"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUPTA",
        "first_name": "AJAY",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-11-29",
        "last_updated": "2009-12-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208G00000X",
            "taxonomy_group": "",
            "desc": "Thoracic Surgery (Cardiothoracic Vascular Surgery)",
            "state": "MI",
            "license": "4301076275",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ypsilanti, MI

Sources for this page

Verify at the official NPI Registry.