Active NPI
Punita Gupta, M.D.
- Specialist
- Chicago, IL
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Specialist
- License
- 25MA09328300
- Practice address
- 840 S Wood St
Chicago, IL 60612-4325 - Phone
- (312) 996-6043
- NPI assigned
- Sep 19, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | 125053691 | IL | |
| Specialist | 174400000X | 25MA09328300 | NJ | Primary |
Addresses
Primary practice location
840 S Wood St
Chicago, IL 60612-4325
Mailing address
21 Read Ave
Tuckahoe, NY 10707-3213
Medicare participation
Medicare enrollment files- 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: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Pediatric Medicine
- Education
- Other, 2002
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
703 Main St
Paterson, NJ 07503-2621
Phone (973) 754-6331
Hospital & facility affiliations
- St Joseph'S University Medical Center Inc
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 25MA09328300 | NJ | MD | Specialist |
| 125053691 | IL | MD | Student in an Organized Health Care Education/Training Program |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| St. Joseph'S Healthcare, Inc. | Current | Accepting new patients | |
| St Josephs Medical Group PC | Current | Accepting new patients |
Locations
703 Main St
Bldg 400
Paterson, NJ 07503
Phone (973) 754-2054
703 Main St
Rm XG2126
Paterson, NJ 07503
Phone (973) 754-2240
703 Main St
#G
Paterson, NJ 07503
Phone (973) 754-6331
703 Main St
Paterson, NJ 07503
Phone (973) 754-2240
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.
-
- Internal Medicine Physician
- Paterson, NJ
- NPI 1205425519
-
- Internal Medicine Physician
- Paterson, NJ
- NPI 1497791297
Hospital & facility affiliations 1
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Paterson, NJ
- NPI 1669462420
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1190160000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1374624000000",
"number": "1073709457",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "21 READ AVE",
"city": "TUCKAHOE",
"state": "NY",
"postal_code": "107073213"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "840 S WOOD ST",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606124325",
"telephone_number": "312-996-6043"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GUPTA",
"first_name": "PUNITA",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-09-19",
"last_updated": "2013-07-24",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": "IL",
"license": "125053691",
"primary": false
},
{
"code": "174400000X",
"taxonomy_group": "",
"desc": "Specialist",
"state": "NJ",
"license": "25MA09328300",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Chicago, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 2013; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.