Organization Active NPI

Dr Rakesh Gupta-Dr Meenu Gupta Medical PC

  • Specialist
  • Forest Hills, NY
National Provider Identifier
1104030626
Registry record updated Apr 23, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
231047 Issued in NY
Legal business name
DR RAKESH GUPTA-DR MEENU GUPTA MEDICAL PC
Practice address
10555 62ND Dr
Forest Hills, NY 11375-1101
Phone
(516) 238-4235
NPI assigned
May 10, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 23, 2012

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

Authorized official

Name
Gina Marie Vega
Title
Office Manager
Phone
(516) 238-4235

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193200000X MULTI-SPECIALTY GROUP 174400000X 231047 NY Primary
SpecialistGroup: 193200000X MULTI-SPECIALTY GROUP 174400000X 218280 NY

Addresses

Primary practice location

10555 62ND Dr
Forest Hills, NY 11375-1101

Mailing address

11312 Jewel Ave
Forest Hills, NY 11375-3953
Phone (516) 488-0241

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20051103000225 NY Part B Supplier - Clinic/Group Practice 4486672979 Receives reassigned benefits from 2 practitioners
Practice locations: Forest Hills, NY

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1178755200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1335139200000",
    "number": "1104030626",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11312 JEWEL AVE",
            "city": "FOREST HILLS",
            "state": "NY",
            "postal_code": "113753953",
            "telephone_number": "516-488-0241"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10555 62ND DR",
            "city": "FOREST HILLS",
            "state": "NY",
            "postal_code": "113751101",
            "telephone_number": "516-238-4235"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR RAKESH GUPTA-DR MEENU GUPTA MEDICAL PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-10",
        "last_updated": "2012-04-23",
        "status": "A",
        "authorized_official_last_name": "VEGA",
        "authorized_official_first_name": "GINA MARIE",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "516-238-4235"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Specialist",
            "state": "NY",
            "license": "231047",
            "primary": true
        },
        {
            "code": "174400000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Specialist",
            "state": "NY",
            "license": "218280",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Forest Hills, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 23, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.