NPIMap

Individual provider Active NPI

Garima Gupta, MD

  • Nephrology Physician
  • Fort Wayne, IN
National Provider Identifier
1073729125
Registry record updated Mar 6, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
01066542A Issued in IN
Practice address
11104 Parkview Circle Dr Ste 330
Fort Wayne, IN 46845-1674
Phone
(260) 471-5114
Fax
(260) 417-5507
NPI assigned
May 15, 2007
Last updated
Mar 6, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 6, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology Physician 207RN0300X 35.098119 OH
Nephrology Physician 207RN0300X 01066542A IN Primary

Addresses

Primary practice location

11104 Parkview Circle Dr Ste 330
Fort Wayne, IN 46845-1674

Mailing address

120 W 22ND St
Oak Brook, IL 60523-1557

Other practice location 1

550 S Landmark Ave
Bloomington, IN 47403-3239
Phone (812) 676-4660

Other identifiers 3

IdentifierTypeStateIssuer
00246075MedicaidNY
200945110OtherINMEDICAID
3002762MedicaidOH

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address credentialing@nephdocs.com
Direct Messaging Address ggupta@direct.iuhealth.org Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN, OH2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20090714000741 IN Practitioner - NephrologyPractitioner - Internal Medicine 0345392858 Reassigns benefits to 3 organizations
I20120221001092 OH Practitioner - Nephrology 0345392858 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nephrology
Education
Other, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Nephrology Associates of Northern Indiana PCGroup PAC ID 8921033440, 64 clinicians

Practice addresses (Care Compare)

11104 Parkview Circle Dr
Suite 330
Fort Wayne, IN 46845-1674
Phone (260) 494-3484

140 Fox Rd
Suite 405
Van Wert, OH 45891-3406
Phone (630) 573-5000

1453 N Baldwin Ave
Nephrology Associates of Northern Indiana P
Marion, IN 46952-1926
Phone (765) 662-2398

1833 Magnavox Way
Suite 100
Fort Wayne, IN 46804-1539
Phone (260) 918-0997

442 W High St
Bryan, OH 43506-1681
Phone (260) 471-5114

569 Tyler St
Gary, IN 46402-1829
Phone (260) 885-3300

7836 W Jefferson Blvd
101 Nephrology Associates of Northern India
Fort Wayne, IN 46804-4178
Phone (260) 494-3484

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
35.098119OHMDNephrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Indiana University Health Southern Indiana Physicians, LLC Internal Medicine CurrentSince Mar 15, 2025 Accepting new patients
Indiana University Health Southern Indiana Physicians LLC CurrentSince Mar 15, 2025 Accepting new patients
Iu Health Medical Group, LLC CurrentSince Jan 4, 2026 Accepting new patients
Nephrology Associates of Northern Indiana, Inc Nephrology CurrentSince Dec 1, 2010 Accepting new patients
Lima Memorial Joint Operating Company Past Accepting new patients

Locations

120 W 22nd St
Oak Brook, IL 60523

120 W 22nd St
Ste 200
Oak Brook, IL 60523
Phone (630) 575-5000

550 S Landmark Ave
Bloomington, IN 47403
Phone (812) 330-3688

727 W 2nd St
Bloomington, IN 47403
Phone (812) 353-3450

11104 Parkview Circle Dr
Ste 330
Fort Wayne, IN 46845
Phone (888) 543-6397

3124 E State Blvd
Ste 6A
Fort Wayne, IN 46805

7910 W Jefferson Blvd
Ste 205
Fort Wayne, IN 46804
Phone (260) 432-8069

569 Tyler St
Gary, IN 46402
Phone (260) 885-3300

1701 Senate Blvd
Indianapolis, IN 46202
Phone (317) 612-2754

250 N Shadeland Ave
Indianapolis, IN 46219
Phone (317) 948-9174

90 W 86th Ave
Merrillville, IN 46410
Phone (219) 791-1555

140 Fox Rd
Ste 405
Van Wert, OH 45891
Phone (419) 238-9333

Interoperability endpoints

  • Direct secure messaging: ggupta@direct.iuhealth.org
  • Direct secure messaging: ggupta42459@direct.acumenmd.com
  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 14

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1179187200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741219200000",
    "number": "1073729125",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "120 W 22ND ST",
            "city": "OAK BROOK",
            "state": "IL",
            "postal_code": "605231557"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11104 PARKVIEW CIRCLE DR STE 330",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468451674",
            "telephone_number": "260-471-5114",
            "fax_number": "260-417-5507"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "550 S Landmark Ave",
            "address_purpose": "LOCATION",
            "city": "Bloomington",
            "state": "IN",
            "postal_code": "474033239",
            "country_code": "US",
            "telephone_number": "812-676-4660",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GUPTA",
        "first_name": "GARIMA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-15",
        "last_updated": "2025-03-06",
        "certification_date": "2025-03-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "OH",
            "license": "35.098119",
            "primary": false
        },
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "IN",
            "license": "01066542A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00246075",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAID",
            "identifier": "200945110",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3002762",
            "state": "OH"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "credentialing@nephdocs.com",
            "affiliation": "N",
            "address_1": "120 W 22nd St Ste 200",
            "city": "Oak Brook",
            "state": "IL",
            "country_code": "US",
            "postal_code": "605231563",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ggupta@direct.iuhealth.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "550 S Landmark Ave",
            "city": "Bloomington",
            "state": "IN",
            "country_code": "US",
            "postal_code": "474033239",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Fort Wayne, IN

Sources for this page

Verify at the official NPI Registry.