Simran Gupta, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

25MP00633900 Issued in NJ

Practice address

1 Ethel Rd Ste 106D
Edison, NJ 08817-2838

Phone

(732) 650-0040

NPI assigned

Jul 29, 2021

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NJ

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

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.

• Advanced Cardiovascular Medicine, LLC

  • Cardiovascular Disease Physician
  • Edison, NJ
  • NPI 1699789917
  Medicare reassignment

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

{
    "created_epoch": "1627516800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1627516800000",
    "number": "1043983695",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4 HENRY MARSHALL DR",
            "city": "TRENTON",
            "state": "NJ",
            "postal_code": "086209673",
            "telephone_number": "609-433-7098"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 ETHEL RD STE 106D",
            "city": "EDISON",
            "state": "NJ",
            "postal_code": "088172838",
            "telephone_number": "732-650-0040"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUPTA",
        "first_name": "SIMRAN",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-07-29",
        "last_updated": "2021-07-29",
        "certification_date": "2021-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NJ",
            "license": "25MP00633900",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Divya Gupta, MD
• Juhee Gupta, MD
• Neha Gupta, M.D.
• Pankaj Gupta, MD, MBA
• Simhadri M Gupta, MD
• Geetha Gurrala, M.D
• Milana Gurshumova, RD
• Gurvindra Singh Johal DO PA Inc.
• Nathalie Gustave, R.N
• Ryan Gutierrez

• Physician Assistant in Edison, NJ
• Providers in Edison, NJ by specialty
• Physician Assistant in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.