Individual provider Active NPI

Rajan Gupta, M.D.

  • Pain Medicine (Physical Medicine & Rehabilitation) Physician
  • Cherry Hill, NJ
National Provider Identifier
1114997962
Registry record updated Mar 8, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pain Medicine (Physical Medicine & Rehabilitation) PhysicianTaxonomy code 2081P2900X
License
MA07713800 Issued in NJ
Practice address
100 Springdale Rd Ste B5
Cherry Hill, NJ 08003-3366
Phone
(856) 482-7246
Fax
(856) 482-7245
NPI assigned
Jan 25, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 8, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pain Medicine (Physical Medicine & Rehabilitation) Physician 2081P2900X MA07713800 NJ Primary

Addresses

Primary practice location

100 Springdale Rd Ste B5
Cherry Hill, NJ 08003-3366

Mailing address

100 Springdale Rd Ste B5
Cherry Hill, NJ 08003-3366
Phone (856) 482-7246

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060822000240 NJ Practitioner - Physical Medicine and Rehabilitation 5193794857 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Medicine and Rehabilitation
Education
Other, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

100 Springdale Rd
Suite B5
Cherry Hill, NJ 08003-3366
Phone (856) 482-7246

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MA07713800NJMDPain Medicine (Physical Medicine & Rehabilitation) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Neighborcare Home Medical Equipment LLC CurrentSince Sep 29, 2004 Accepting new patients
Pain Instacure, LLC Current Accepting new patients
Gupta Institute for Pain, Wellness and Rehabilitation, LLC Pain Medicine CurrentSince Mar 1, 2006 Accepting new patients
Southeast Regional Pain Ctr PC PastSince Apr 12, 2018 Accepting new patients

Locations

1020 Kings Hwy N
Ste 106
Cherry Hill, NJ 08034
Phone (855) 727-2465

100 Springdale Rd
Ste B5
Cherry Hill, NJ 08003
Phone (856) 482-7246

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/BAFHDD
  • FHIR API: https://fhir-api.fhirprod.aws.greenwayhealth.com/fhir/R4/2.16.840.1.113883.3.140.60964

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1138147200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1615161600000",
    "number": "1114997962",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 SPRINGDALE RD STE B5",
            "city": "CHERRY HILL",
            "state": "NJ",
            "postal_code": "080033366",
            "telephone_number": "856-482-7246",
            "fax_number": "856-482-7245"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 SPRINGDALE RD STE B5",
            "city": "CHERRY HILL",
            "state": "NJ",
            "postal_code": "080033366",
            "telephone_number": "856-482-7246",
            "fax_number": "856-482-7245"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUPTA",
        "first_name": "RAJAN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-01-25",
        "last_updated": "2021-03-08",
        "certification_date": "2021-03-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2081P2900X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation, Pain Medicine",
            "state": "NJ",
            "license": "MA07713800",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cherry Hill, NJ

Sources for this page

Verify at the official NPI Registry.