NPIMap

Individual provider Active NPI

Ankur Gupta, M.D.

  • Vascular Surgery Physician
  • Long Beach, CA
National Provider Identifier
1083854582
Registry record updated Nov 2, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular Surgery PhysicianTaxonomy code 2086S0129X
License
A104116 Issued in CA
Practice address
701 E 28TH St Ste 314
Long Beach, CA 90806-2702
Phone
(562) 981-9308
Fax
(562) 981-9318
NPI assigned
Feb 24, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 2, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X A104116 CA
Vascular Surgery Physician 2086S0129X A104116 CA Primary

Addresses

Primary practice location

701 E 28TH St Ste 314
Long Beach, CA 90806-2702

Mailing address

PO Box 3672
Los Altos, CA 94024-0672
Phone (650) 224-8977

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120604000343 CA Practitioner - Vascular SurgeryPractitioner - General SurgeryPractitioner - Other (Physician) 9133383185 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Vascular SurgeryAlso: General Surgery
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

701 E 28TH St
Suite 400
Long Beach, CA 90806-2778
Phone (562) 981-9308

Hospital & facility affiliations

  • Hygieia Home Health Inc Home health agency, Lakewood, CA, CCN 557541
  • Uci Health-Orange Hospital, Orange, CA, CCN 050348
  • Memorialcare Long Beach Medical Center Hospital, Long Beach, CA, CCN 050485
  • St Mary Medical Center Hospital, Long Beach, CA, CCN 050191
  • Martin Luther King, Jr. Community Hospital Hospital, Los Angeles, CA, CCN 050779

Procedures performed for Medicare patients

ProcedureNumber of procedures
Leg revascularization (restoring blood flow)21
Removal of tissue161

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A104116CAMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Joseph Vardayo M D Inc CurrentSince Aug 1, 2015 Accepting new patients
Ankur Gupta MD Inc Vascular Surgery CurrentSince Jan 4, 2017 Accepting new patients
Long Beach Memorial Medical Past Accepting new patients
St. Mary Medical Center Past Accepting new patients
Los Alamitos Medical Center, Inc. Past Accepting new patients
B&B Medical Group Inc PastSince Nov 1, 2021 Accepting new patients
Long Beach Memorial Medical Past Accepting new patients
University of California Irvine Past Accepting new patients
Orange Coast Memorial Medical Center Past Accepting new patients

Locations

701 E 28th St
Ste 400
Long Beach, CA 90806
Phone (562) 424-6040

701 E 28th St
Ste 314
Long Beach, CA 90806
Phone (562) 595-8599

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 9

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 6

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": "1235433600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1604275200000",
    "number": "1083854582",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3672",
            "city": "LOS ALTOS",
            "state": "CA",
            "postal_code": "940240672",
            "telephone_number": "650-224-8977"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "701 E 28TH ST STE 314",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908062702",
            "telephone_number": "562-981-9308",
            "fax_number": "562-981-9318"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUPTA",
        "first_name": "ANKUR",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-02-24",
        "last_updated": "2020-11-02",
        "certification_date": "2020-11-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "CA",
            "license": "A104116",
            "primary": false
        },
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "CA",
            "license": "A104116",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Long Beach, CA

Sources for this page

Verify at the official NPI Registry.