Pravin Gupta, M.D.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

9-320 Issued in WI

Practice address

36500 Aurora Dr
Summit, WI 53066-4899

Phone

(262) 434-1000

Fax

(515) 471-9320

NPI assigned

Aug 18, 2006

Last updated

Jul 21, 2022By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Pravin Gupta M.D., P.C.

  • Internal Medicine Physician
  • Munster, IN
  • NPI 1861679813
  NPD (past) Authorized official
• Krishnakant Raiker MD PC

  • Cardiovascular Disease Physician
  • Munster, IN
  • NPI 1033127691

  Internal Medicine

  NPD (past)
• Mercy Services Iowa City, Inc.

  • Primary Care Clinic/Center
  • West Liberty, IA
  • NPI 1477065332
  NPD (past)
• Northwest Indiana Nephrology PC

  • Nephrology Physician
  • Valparaiso, IN
  • NPI 1285991885
  NPD (past)
• Porter Health Services

  dba Westchester Medical Group

  • Family Medicine Physician
  • Chesterton, IN
  • NPI 1164483590

  Internal Medicine

  NPD (past)
• Southeast Iowa Regional Medical Center, Inc.

  dba Southeast Iowa Regional Medical Center

  • General Practice Physician
  • West Burlington, IA
  • NPI 1164433884
  NPD (past)

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

{
    "created_epoch": "1155859200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1124132188",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "36500 AURORA DR",
            "city": "SUMMIT",
            "state": "WI",
            "postal_code": "530664899",
            "telephone_number": "262-434-1000",
            "fax_number": "515-471-9320"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "36500 AURORA DR",
            "city": "SUMMIT",
            "state": "WI",
            "postal_code": "530664899",
            "telephone_number": "262-434-1000",
            "fax_number": "515-471-9320"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1001 N Center Point Rd Ste C",
            "address_purpose": "LOCATION",
            "city": "Hiawatha",
            "state": "IA",
            "postal_code": "522331237",
            "country_code": "US",
            "telephone_number": "319-362-0200",
            "fax_number": "319-375-6199",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GUPTA",
        "first_name": "PRAVIN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-18",
        "last_updated": "2022-07-21",
        "certification_date": "2020-01-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IN",
            "license": "01039588",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IA",
            "license": "40674",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "WI",
            "license": "9-320",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100072887",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jamie L Goehner, M.D.
• Elaine Gonya, LAT, ATC
• Kira Greenwood
• Judith A Gresky, NP
• Christina Grimord, DPT
• Alexander Haberman, DO
• Kathryn M Haberman, MD
• Jacqueline N Hale, PA-C
• Derek Hanaman, MPT
• Sandra R Hansen, PA-C

• Internal Medicine Physician in Summit, WI
• Providers in Summit, WI by specialty
• Internal Medicine Physician in Wisconsin

• 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.