Individual provider Active NPI

Supriya Gupta, MBBS

  • Hematology (Internal Medicine) Physician
  • Rochester, MN
National Provider Identifier
1124540604
Registry record updated Oct 18, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hematology (Internal Medicine) PhysicianTaxonomy code 207RH0000X
License
73769 Issued in MN
Practice address
200 1St St SW
Rochester, MN 55905-0001
Phone
(507) 284-2511
NPI assigned
Jul 17, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 18, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Hematology (Internal Medicine) Physician 207RH0000X 73769 MN Primary

Addresses

Primary practice location

200 1St St SW
Rochester, MN 55905-0001

Mailing address

200 1St St SW
Rochester, MN 55905-0001
Phone (507) 284-2511

Other practice location 1

1501 Kings Highway
Internal Medicine
Shreveport, LA 71130
Phone (318) 626-0434

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address sgupta1950357@ehrdirect.mayoclinicmsg.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN
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
I20230524002289 MN Practitioner - Hematology 3072979657 Reassigns benefits to 6 organizations

Care Compare profile

Medicare Care Compare
Specialty
Hematology
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Fairview Express CareGroup PAC ID 3375645179, 1,946 clinicians
Fairview Specialty ServicesGroup PAC ID 3072083286, 303 clinicians

Practice addresses (Care Compare)

909 Fulton St SE
Minneapolis, MN 55455-4800
Phone (612) 672-7422

Hospital & facility affiliations

  • M Health Fairview University of MN Medical Center Hospital, Minneapolis, MN, CCN 240080
  • M Health Fairview Southdale Hospital Hospital, Edina, MN, CCN 240078
  • M Health Fairview St John'S Hospital Hospital, Maplewood, MN, CCN 240210

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
University of Minnesota Physicians Current Accepting new patients
Healtheast Medical Research Institute CurrentSince Jun 15, 2024 Accepting new patients
University of Minnesota Physicians CurrentSince Jul 15, 2024 Accepting new patients
University of Minnesota Physicians CurrentSince Jul 15, 2024 Accepting new patients
Healtheast Medical Research Institute CurrentSince Jun 15, 2024 Accepting new patients
Fairview Express Care Current Accepting new patients
Mayo Clinic CurrentSince Jul 1, 2023 Accepting new patients
Fairview Express Care CurrentSince Jun 15, 2024 Accepting new patients
Fairview Express Care CurrentSince Jun 15, 2024 Accepting new patients
Healtheast Medical Research Institute Current Accepting new patients
University of Minnesota Health Clinics and Surgery Center Inc CurrentSince Jul 15, 2024 Accepting new patients
Mayo Clinic CurrentSince Jul 1, 2023 Accepting new patients
University of Minnesota Health Clinics and Surgery Center, Inc. Current Accepting new patients
Fairview Health Services Past Accepting new patients

Locations

909 Fulton St SE
Minneapolis, MN 55455
Phone (612) 273-8383

720 Washington Ave SE
Minneapolis, MN 55414
Phone (612) 883-0649

909 Fulton St SE
Ste 202
Minneapolis, MN 55455
Phone (612) 273-8383

717 Delaware St SE
Ste 340
Minneapolis, MN 55414
Phone (612) 625-3617

200 1st St SW
Rochester, MN 55905
Phone (507) 266-4850

1700 University Ave W
Fl 6
Saint Paul, MN 55104
Phone (651) 232-2273

Interoperability endpoints

  • Direct secure messaging: sgupta923792@fairview.direct-ci.com

Organizations & group practices 15

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.

View all 15

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": "1500249600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1697587200000",
    "number": "1124540604",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 1ST ST SW",
            "city": "ROCHESTER",
            "state": "MN",
            "postal_code": "559050001",
            "telephone_number": "507-284-2511"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 1ST ST SW",
            "city": "ROCHESTER",
            "state": "MN",
            "postal_code": "559050001",
            "telephone_number": "507-284-2511"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1501 Kings Highway",
            "address_2": "Internal Medicine",
            "address_purpose": "LOCATION",
            "city": "Shreveport",
            "state": "LA",
            "postal_code": "71130",
            "country_code": "US",
            "telephone_number": "318-626-0434",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GUPTA",
        "first_name": "SUPRIYA",
        "credential": "MBBS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-07-17",
        "last_updated": "2023-10-18",
        "certification_date": "2023-10-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RH0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology",
            "state": "MN",
            "license": "73769",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "sgupta1950357@ehrdirect.mayoclinicmsg.org",
            "affiliation": "N",
            "address_1": "200 1st St SW",
            "city": "Rochester",
            "state": "MN",
            "country_code": "US",
            "postal_code": "559050001",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Rochester, MN

Sources for this page

Verify at the official NPI Registry.