Individual provider Active NPI

Anu Gupta, M.D.

  • Obstetrics & Gynecology Physician
  • Richardson, TX
National Provider Identifier
1063740728
Registry record updated Aug 29, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
036122170 Issued in IL
Practice address
3201 E President George Bush Hwy
Suite 107
Richardson, TX 75082-3566
Phone
(972) 276-9902
Fax
(972) 276-9819
NPI assigned
Nov 18, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 29, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 036122170 IL Primary
Obstetrics & Gynecology Physician 207V00000X Q2288 TX

Addresses

Primary practice location

3201 E President George Bush Hwy
Suite 107
Richardson, TX 75082-3566

Mailing address

3201 E President George Bush Hwy
Suite 107
Richardson, TX 75082-3566
Phone (972) 276-9902

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20151022002602 TX Practitioner - Obstetrics/Gynecology 1456546878 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Advanced OB-GYN Associates PAGroup PAC ID 2567532294, 2 clinicians

Practice addresses (Care Compare)

3201 E President George Bush Hwy
Suite 107
Richardson, TX 75082-3565
Phone (972) 276-9902

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036122170ILMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Obhg Texas Holdings, P.a. Obstetrics & Gynecology CurrentSince Jul 28, 2015 Accepting new patients
Bonaventure Medical Foundation, LLC Past Accepting new patients

Locations

10 Centimeters Dr
Mauldin, SC 29662
Phone (800) 867-2289

12221 N Mopac Expy
Austin, TX 78758
Phone (512) 901-2530

5950 Saratoga Blvd
Corpus Christi, TX 78414
Phone (321) 917-9263

Interoperability endpoints

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

Organizations & group practices 3

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": "1258502400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1472428800000",
    "number": "1063740728",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3201 E PRESIDENT GEORGE BUSH HWY",
            "address_2": "SUITE 107",
            "city": "RICHARDSON",
            "state": "TX",
            "postal_code": "750823566",
            "telephone_number": "972-276-9902",
            "fax_number": "972-276-9819"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3201 E PRESIDENT GEORGE BUSH HWY",
            "address_2": "SUITE 107",
            "city": "RICHARDSON",
            "state": "TX",
            "postal_code": "750823566",
            "telephone_number": "972-276-9902",
            "fax_number": "972-276-9819"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUPTA",
        "first_name": "ANU",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-11-18",
        "last_updated": "2016-08-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "IL",
            "license": "036122170",
            "primary": true
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "TX",
            "license": "Q2288",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Richardson, TX

Sources for this page

Verify at the official NPI Registry.