Individual provider Active NPI

Priyanka Gupta, MD

  • Urogynecology and Reconstructive Pelvic Surgery (Urology) Physician
  • Ann Arbor, MI
National Provider Identifier
1174758262
Registry record updated Dec 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urogynecology and Reconstructive Pelvic Surgery (Urology) PhysicianTaxonomy code 2088F0040X
License
4301105050 Issued in MI
Practice address
1500 E Medical Center Dr
Ann Arbor, MI 48109-5000
Phone
(734) 936-4000
NPI assigned
May 19, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 18, 2024

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Urogynecology and Reconstructive Pelvic Surgery (Obstetrics & Gynecology) Physician 207VF0040X 4301105050 MI
Urology Physician 208800000X 4301105050 MI
Student in an Organized Health Care Education/Training Program 390200000X
Urogynecology and Reconstructive Pelvic Surgery (Urology) Physician 2088F0040X 4301105050 MI Primary

Addresses

Primary practice location

1500 E Medical Center Dr
Ann Arbor, MI 48109-5000

Mailing address

3621 S State St
Ann Arbor, MI 48108-1633
Phone (734) 647-5299

Other practice location 1

1500 East Medical Center Drive
2nd floor Taubman Center Recp C
Ann Arbor, MI 48109-5330
Phone (734) 936-7030

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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
I20160803000894 MI Practitioner - Urology 7517182405 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Urology
Education
Mayo Medical School, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Regents of the University of MichiganGroup PAC ID 3779496856, 3,344 clinicians
Mymichigan Medical Center MidlandGroup PAC ID 2264323633, 507 clinicians

Practice addresses (Care Compare)

14650 E Old US Hwy 12
Chelsea, MI 48118-1801
Phone (734) 936-7030

1500 E Medical Ctr Dr
Ann Arbor, MI 48109-5000
Phone (734) 936-7030

1500 E Sherman Blvd
Muskegon, MI 49444-1849
Phone (734) 936-7030

19900 Haggerty Rd
Suite 111
Livonia, MI 48152-1054
Phone (734) 936-7030

39901 Traditions Dr
Northville, MI 48168-9493
Phone (734) 936-7030

4100 Campus Ridge Dr
Midland, MI 48640-6139
Phone (989) 839-1386

775 S Main St
Chelsea, MI 48118-1383
Phone (734) 936-7030

Hospital & facility affiliations

  • University of Michigan Health System Hospital, Ann Arbor, MI, CCN 230046
  • Chelsea Hospital Hospital, Chelsea, MI, CCN 230259

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Mymichigan Medical Center Midland CurrentSince Jul 21, 2023 Accepting new patients
Regents of the University of Michigan CurrentSince Jul 26, 2016 Accepting new patients
Regents of the University of Michigan Urology CurrentSince Jul 26, 2016 Accepting new patients
Mymichigan Medical Center Midland CurrentSince Jul 21, 2023 Accepting new patients
Regents of the University of Michigan Past Accepting new patients

Locations

1500 E Medical Center Dr
Fl 2
Ann Arbor, MI 48109
Phone (734) 936-5738

3621 S State St
#700
Ann Arbor, MI 48108

1500 E Medical Center Dr
Ann Arbor, MI 48109
Phone (734) 936-4280

3621 S State St
Ann Arbor, MI 48108
Phone (734) 647-5229

14650 E Old US Highway 12
Chelsea, MI 48118
Phone (734) 475-2600

19900 Haggerty Rd
Ste 111
Livonia, MI 48152
Phone (734) 432-7811

4000 Wellness Dr
Midland, MI 48670
Phone (844) 832-1956

4500 N Campus Ridge Dr
Midland, MI 48640
Phone (989) 837-9250

4100 Campus Ridge Dr
Midland, MI 48640
Phone (989) 488-5450

39901 Traditions Dr
Northville, MI 48168
Phone (248) 305-4400

Interoperability endpoints

  • Direct secure messaging: pgupta703917@direct.med.umich.edu

Organizations & group practices 5

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 2

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": "1242691200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1734480000000",
    "number": "1174758262",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3621 S STATE ST",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481081633",
            "telephone_number": "734-647-5299"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 E MEDICAL CENTER DR",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481095000",
            "telephone_number": "734-936-4000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1500 East Medical Center Drive",
            "address_2": "2nd floor Taubman Center Recp C",
            "address_purpose": "LOCATION",
            "city": "Ann Arbor",
            "state": "MI",
            "postal_code": "481095330",
            "country_code": "US",
            "telephone_number": "734-936-7030",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GUPTA",
        "first_name": "PRIYANKA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-05-19",
        "last_updated": "2024-12-18",
        "certification_date": "2024-12-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207VF0040X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Urogynecology and Reconstructive Pelvic Surgery",
            "state": "MI",
            "license": "4301105050",
            "primary": false
        },
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "MI",
            "license": "4301105050",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2088F0040X",
            "taxonomy_group": "",
            "desc": "Urology, Urogynecology and Reconstructive Pelvic Surgery",
            "state": "MI",
            "license": "4301105050",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ann Arbor, MI

Sources for this page

Verify at the official NPI Registry.