Individual provider Active NPI

Prashant Gupta, M.D.

  • Family Medicine Physician
  • Burien, WA
National Provider Identifier
1043552862
Registry record updated Jul 10, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
60660929 Issued in WA
Practice address
16045 1St Ave S # F1
Burien, WA 98148
Phone
(206) 965-4180
Fax
(206) 965-4199
NPI assigned
Mar 19, 2013
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 10, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 036138919 IL
Family Medicine Physician 207Q00000X 60660929 WA Primary

Addresses

Primary practice location

16045 1St Ave S # F1
Burien, WA 98148

Mailing address

16045 1St Ave S # F1
Burien, WA 98148-1401
Phone (206) 965-4180

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA, OR2 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
I20160920000706 WA Practitioner - Emergency MedicinePractitioner - Family Practice 6507161858 Reassigns benefits to 2 organizations
I20210204002664 OR Practitioner - Family Practice 6507161858 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Emergency MedicineAlso: Family Practice
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
King County Public Hospital District No 2Group PAC ID 7618880097, 586 clinicians

Practice addresses (Care Compare)

12040 NE 128TH St
Kirkland, WA 98034-3013
Phone (425) 899-1000

Hospital & facility affiliations

  • Evergreenhealth Medical Center Hospital, Kirkland, WA, CCN 500124

Merit-based Incentive Payment System (MIPS)

Final score
86.73 of 100Reported as apm
Quality
73.46
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
60660929WAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
King County Public Hospital District No 2 Current Accepting new patients
Kaiser Foundation Health Plan of the Northwest CurrentSince Dec 14, 2020 Accepting new patients
King County Public Hospital District No 2 Family Medicine Current Accepting new patients
King County Public Hospital District No. 2 Family Medicine CurrentSince Dec 1, 2020 Accepting new patients
Kaiser Foundation Health Plan of the Northwest Family Medicine CurrentSince Dec 14, 2020 Accepting new patients
Kaiser Foundation Health Plan of the Northwest Family Medicine CurrentSince Dec 14, 2020 Accepting new patients
King County Public Hospital District No. 2 CurrentSince Dec 1, 2020 Accepting new patients
King County Public Hospital District No 2 Past Accepting new patients

Locations

10100 SE Sunnyside Rd
Clackamas, OR 97015
Phone (503) 571-2946

7201 N Interstate Ave
Portland, OR 97217
Phone (503) 240-4051

2400 Lancaster Dr NE
Salem, OR 97305
Phone (503) 361-5400

1909 214th St SE
Ste 110
Bothell, WA 98021
Phone (425) 488-4988

14720 Main St NE
Ste 109
Duvall, WA 98019
Phone (425) 788-4889

12040 NE 128th St
#50
Kirkland, WA 98034
Phone (425) 899-1894

12040 NE 128th St
Kirkland, WA 98034
Phone (425) 899-1000

12039 NE 128th St
Ste 300
Kirkland, WA 98034
Phone (425) 899-3123

1230 7th Ave
Longview, WA 98632
Phone (360) 575-4801

7101 NE 137th Ave
Vancouver, WA 98682
Phone (360) 418-6000

12607 SE Mill Plain Blvd
Vancouver, WA 98684
Phone (360) 418-6001

Organizations & group practices 8

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 1

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": "1363651200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1562716800000",
    "number": "1043552862",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16045 1ST AVE S # F1",
            "city": "BURIEN",
            "state": "WA",
            "postal_code": "981481401",
            "telephone_number": "206-965-4180",
            "fax_number": "206-965-4199"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16045 1ST AVE S # F1",
            "city": "BURIEN",
            "state": "WA",
            "postal_code": "98148",
            "telephone_number": "206-965-4180",
            "fax_number": "206-965-4199"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUPTA",
        "first_name": "PRASHANT",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-03-19",
        "last_updated": "2019-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036138919",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WA",
            "license": "60660929",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Burien, WA

Sources for this page

Verify at the official NPI Registry.