NPIMap

Organization Active NPI

Urology Medical Specialists, PA

  • Urology Physician
  • Coconut Creek, FL
National Provider Identifier
1164772935
Registry record updated Mar 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
Legal business name
UROLOGY MEDICAL SPECIALISTS, PA
Practice address
4515 Wiles Rd Ste 201
Coconut Creek, FL 33073-3414
Phone
(954) 943-1133
Fax
(954) 783-6845
NPI assigned
Sep 19, 2012
Last updated
Mar 29, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 29, 2024

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

Authorized official

Name
Dr. Sanjeev K Gupta, M.D.NPI 1457560443
Title
President
Phone
(954) 943-1133

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
Durable Medical Equipment & Medical Supplies 332B00000X
Urology Physician 208800000X Primary

Addresses

Primary practice location

4515 Wiles Rd Ste 201
Coconut Creek, FL 33073-3414

Mailing address

5258 Linton Blvd Ste 203
Delray Beach, FL 33484-6529
Phone (561) 495-7570

Other practice location 1

601 E Sample Rd Ste 105
Deerfield Beach, FL 33064-4443
Phone (954) 943-1133

Other practice location 2

5258 Linton Blvd Ste 203
Delray Beach, FL 33484-6529
Phone (561) 495-7570

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20121214000246 FL Part B Supplier - Clinic/Group Practice 2466604616 Receives reassigned benefits from 15 practitioners
Practice locations: Delray Beach, FL; Plantation, FL; Fort Lauderdale, FL; Deerfield Beach, FL; Coconut Creek, FL

Other NPIs with the same Medicare PAC ID 2

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory

Locations

1930 NE 47th St
Ste 308
Ft Lauderdale, FL 33308
Phone (954) 493-5005

Networks

  • HealthSun Health Plans Network

Practitioners & affiliated clinicians

Practitioners 15

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1348012800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1711670400000",
    "number": "1164772935",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5258 LINTON BLVD STE 203",
            "city": "DELRAY BEACH",
            "state": "FL",
            "postal_code": "334846529",
            "telephone_number": "561-495-7570",
            "fax_number": "561-496-7074"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4515 WILES RD STE 201",
            "city": "COCONUT CREEK",
            "state": "FL",
            "postal_code": "330733414",
            "telephone_number": "954-943-1133",
            "fax_number": "954-783-6845"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "601 E Sample Rd Ste 105",
            "address_purpose": "LOCATION",
            "city": "Deerfield Beach",
            "state": "FL",
            "postal_code": "330644443",
            "country_code": "US",
            "telephone_number": "954-943-1133",
            "fax_number": "954-783-6845",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5258 Linton Blvd Ste 203",
            "address_purpose": "LOCATION",
            "city": "Delray Beach",
            "state": "FL",
            "postal_code": "334846529",
            "country_code": "US",
            "telephone_number": "561-495-7570",
            "fax_number": "561-496-7074",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "UROLOGY MEDICAL SPECIALISTS, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-09-19",
        "last_updated": "2024-03-29",
        "certification_date": "2024-03-29",
        "status": "A",
        "authorized_official_last_name": "GUPTA",
        "authorized_official_first_name": "SANJEEV",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "954-943-1133",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Coconut Creek, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 29, 2024; 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.