Organization Active NPI

Gupta Heart and Vascular Center of Las Vegas PC

  • Cardiovascular Disease Physician
  • Las Vegas, NV
National Provider Identifier
1104204080
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
Legal business name
GUPTA HEART AND VASCULAR CENTER OF LAS VEGAS PC
Practice address
10170 W Tropicana Ave
# 156-306
Las Vegas, NV 89147-8465
Phone
(702) 321-1513
NPI assigned
May 12, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Authorized official

Name
Mr. Manish P Gupta, M.DNPI 1528250966
Title
Ceo
Phone
(702) 321-1513

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RC0000X Primary
Medical Specialty Clinic/Center 261QM2500X NV

Addresses

Primary practice location

10170 W Tropicana Ave
# 156-306
Las Vegas, NV 89147-8465

Mailing address

10170 W Tropicana Ave
# 156-306
Las Vegas, NV 89147-8465
Phone (702) 321-1513

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20151013000814 NV Part B Supplier - Clinic/Group Practice 6002125176 Receives reassigned benefits from 1 practitioner
Practice locations: Las Vegas, NV

National Provider Directory

National Provider Directory

Locations

10170 W Tropicana Ave
Ste 156306
Las Vegas, NV 89147
Phone (718) 755-9073

6090 S Fort Apache Rd
Ste 130
Las Vegas, NV 89148
Phone (602) 550-4065

Practitioners & affiliated clinicians

Practitioners 1

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": "1431388800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1104204080",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10170 W TROPICANA AVE",
            "address_2": "# 156-306",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891478465",
            "telephone_number": "702-321-1513"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10170 W TROPICANA AVE",
            "address_2": "# 156-306",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891478465",
            "telephone_number": "702-321-1513"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GUPTA HEART AND VASCULAR CENTER OF LAS VEGAS PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-05-12",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "GUPTA",
        "authorized_official_first_name": "MANISH",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "702-321-1513",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "M.D"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QM2500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Medical Specialty",
            "state": "NV",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Vegas, NV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.