Individual provider Active NPI

Mohit K Gupta, M.D.

  • Diagnostic Radiology Physician
  • Marietta, GA
National Provider Identifier
1164777934
Registry record updated Feb 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
080469 Issued in GA
Practice address
790 Church St NE Ste 400
Marietta, GA 30060
Phone
(770) 952-8899
NPI assigned
Jul 18, 2012
Last updated
Feb 19, 2024By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 19, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 036142358 IL
Diagnostic Radiology Physician 2085R0202X 080469 GA Primary

Addresses

Primary practice location

790 Church St NE Ste 400
Marietta, GA 30060

Mailing address

PO Box 3157
Indianapolis, IN 46206-3157
Phone (770) 405-2976

Other practice location 1

676 N Saint Clair St Ste 800
Chicago, IL 60611-2978
Phone (513) 289-6160

Other practice location 2

2650 Ridge Ave
Evanston, IL 60201-1718
Phone (847) 570-2509

Other identifiers 1

IdentifierTypeStateIssuer
1164777934MedicaidIL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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
I20180903000000 GA Practitioner - Diagnostic Radiology 7517231467 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
University of Cincinnati College of Medicine, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Quantum Radiology PCGroup PAC ID 4385543230, 105 clinicians

Practice addresses (Care Compare)

3000 Hospital Blvd
Roswell, GA 30076-4915
Phone (770) 751-2500

3747 Roswell Rd
Marietta, GA 30062-6215
Phone (470) 956-8765

3950 Austell Rd
Austell, GA 30106-1121
Phone (770) 732-4000

60 Lacy St NW
Marietta, GA 30060-1112
Phone (770) 793-7800

677 Church St NE
Marietta, GA 30060-1101
Phone (770) 793-5000

925 Sanders Rd
Suite B
Cumming, GA 30041-7945
Phone (678) 513-0500

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
93.93 of 100Reported as apm
Quality
82.14
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Pro Radiology, LLC CurrentSince Jul 21, 2024 Accepting new patients
Quantum Radiology, PC Diagnostic Radiology CurrentSince Aug 1, 2018 Accepting new patients
Synergy Radiology, LLC Diagnostic Radiology CurrentSince Jun 26, 2018 Accepting new patients
M & B Imaging, PC Diagnostic Radiology CurrentSince Aug 20, 2020 Accepting new patients
Diagnostic Systems Inc Diagnostic Radiology PastSince Jan 1, 2019 Accepting new patients
Synergy Radiology, LLC PastSince Jul 21, 2024 Accepting new patients

Locations (25 of 60)

4550 Cobb Parkway North NW
Ste 109
Acworth, GA 30101
Phone (470) 956-0079

12460 Crabapple Rd
Alpharetta, GA 30004
Phone (678) 762-0574

2450 Old Milton Pkwy
Alpharetta, GA 30009
Phone (470) 267-0360

5655 Atlanta Hwy
Alpharetta, GA 30004
Phone (770) 691-0819

3730 Carmia Dr SW
Ste 110
Atlanta, GA 30331
Phone (404) 344-7286

3890 Redwine Rd SW
Ste 104
Atlanta, GA 30331
Phone (404) 629-4700

60 Peachtree Park Dr NE
#100
Atlanta, GA 30309
Phone (678) 278-8800

1025 E West Connector
Ste 520
Austell, GA 30106
Phone (678) 273-3071

1625 Hospital North Dr
Austell, GA 30106
Phone (770) 732-6950

1680 Hospital South Dr
Austell, GA 30106
Phone (678) 945-2100

3950 Austell Rd
Austell, GA 30106
Phone (770) 732-3752

1501 Milstead Rd NE
Ste 140
Conyers, GA 30012

925 Sanders Rd
Cumming, GA 30041
Phone (404) 567-6500

120 Greystone Power Blvd
Dallas, GA 30157
Phone (470) 267-1540

6001 Professional Pkwy
Douglasville, GA 30134
Phone (404) 274-7335

6002 Professional Pkwy
Ste 260
Douglasville, GA 30134
Phone (770) 428-4486

8954 Hospital Dr
Douglasville, GA 30134
Phone (678) 838-2584

4244 Washington Rd
Evans, GA 30809
Phone (706) 619-1869

307 W Robinson Ave
Grovetown, GA 30813

144 Bill Carruth Pkwy
Hiram, GA 30141

148 Bill Carruth Pkwy
Ste LL20
Hiram, GA 30141
Phone (770) 443-7700

2518 Jimmy Lee Smith Pkwy
Hiram, GA 30141
Phone (470) 644-7000

1120 Wellstar Way
Holly Springs, GA 30114

1180 Ernest W Barrett Pkwy NW
#100
Kennesaw, GA 30144
Phone (770) 644-1274

1550 Kennesaw Due West Rd NW
Kennesaw, GA 30152
Phone (770) 423-9525

Organizations & group practices 6

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.

Hospital & facility affiliations 5

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": "1342569600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1708300800000",
    "number": "1164777934",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3157",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462063157",
            "telephone_number": "770-405-2976"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "790 CHURCH ST NE STE 400",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "30060",
            "telephone_number": "770-952-8899"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "676 N Saint Clair St Ste 800",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606112978",
            "country_code": "US",
            "telephone_number": "513-289-6160",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2650 Ridge Ave",
            "address_purpose": "LOCATION",
            "city": "Evanston",
            "state": "IL",
            "postal_code": "602011718",
            "country_code": "US",
            "telephone_number": "847-570-2509",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GUPTA",
        "first_name": "MOHIT",
        "middle_name": "K",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-07-18",
        "last_updated": "2024-02-19",
        "certification_date": "2024-02-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "IL",
            "license": "036142358",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "GA",
            "license": "080469",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1164777934",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Marietta, GA

Sources for this page

Verify at the official NPI Registry.