Individual provider Active NPI

Malini Gupta, M.D.

  • Endocrinology, Diabetes & Metabolism Physician
  • Memphis, TN
National Provider Identifier
1164626248
Registry record updated Aug 5, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Endocrinology, Diabetes & Metabolism PhysicianTaxonomy code 207RE0101X
License
44216 Issued in TN
Practice address
6005 Park Ave
Suite 510
Memphis, TN 38119-5202
Phone
(901) 537-7000
Fax
(901) 537-3500
NPI assigned
Jun 13, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 5, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Endocrinology, Diabetes & Metabolism Physician 207RE0101X 44216 TN Primary

Addresses

Primary practice location

6005 Park Ave
Suite 510
Memphis, TN 38119-5202

Mailing address

6005 Park Ave
Suite 510
Memphis, TN 38119-5202
Phone (901) 537-7000

Other identifiers 1

IdentifierTypeStateIssuer
103I469584OtherTNMEDICARE PTAN

Other names 1

  • Malini Gupta-Ganguli Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
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
I20101207000512 TN Practitioner - EndocrinologyPractitioner - Internal Medicine 6103013867 Reassigns benefits to 1 organization
Practice locations: Memphis, TN

Care Compare profile

Medicare Care Compare
Specialty
EndocrinologyAlso: Internal Medicine
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Consolidated Medical Practices of Memphis,PLLCGroup PAC ID 1759459845, 113 clinicians

Practice addresses (Care Compare)

6799 Great Oaks Rd
Suite 250
Memphis, TN 38138-2584
Phone (901) 261-0700

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
44216TNMDLicensed Practical Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Consolidated Medical Practices of Memphis,PLLC CurrentSince Jul 15, 2014 Accepting new patients

Locations

6005 Park Ave
Ste 510
Memphis, TN 38119
Phone (901) 537-7000

6005 Park Ave
Ste 409
Memphis, TN 38119
Phone (901) 681-9670

6799 Great Oaks Rd
Ste 250
Memphis, TN 38138
Phone (901) 261-0700

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/IBHBDD

Organizations & group practices 1

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.

Hospital & facility affiliations 1

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": "1181692800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1470355200000",
    "number": "1164626248",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6005 PARK AVE",
            "address_2": "SUITE 510",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381195202",
            "telephone_number": "901-537-7000",
            "fax_number": "901-537-3500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6005 PARK AVE",
            "address_2": "SUITE 510",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381195202",
            "telephone_number": "901-537-7000",
            "fax_number": "901-537-3500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUPTA",
        "first_name": "MALINI",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-06-13",
        "last_updated": "2016-08-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RE0101X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "TN",
            "license": "44216",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "103I469584",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MALINI",
            "last_name": "GUPTA-GANGULI",
            "credential": "M.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Memphis, TN

Sources for this page

Verify at the official NPI Registry.