Individual provider Active NPI

Jessica Gupta, M.D.

  • Internal Medicine Physician
  • Orlando, FL
National Provider Identifier
1174941413
Registry record updated Sep 27, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
ME142672 Issued in FL
Practice address
86 W Underwood St
Orlando, FL 32806-1110
Phone
(888) 912-3648
Fax
(321) 841-4085
NPI assigned
Apr 3, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 27, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 289944 NY
Internal Medicine Physician 207R00000X ME142672 FL Primary

Addresses

Primary practice location

86 W Underwood St
Orlando, FL 32806-1110

Mailing address

86 W Underwood St
Orlando, FL 32806-1110
Phone (888) 912-3648

Other practice location 1

601 Elmwood Avenue Box Med/Hmd
Rochester, NY 14642-0001
Phone (585) 275-4912

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20191023003187 FL Practitioner - Internal Medicine 6709159817 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Orlando Health Medical Group IncGroup PAC ID 9537059084, 2,171 clinicians

Practice addresses (Care Compare)

86 W Underwood St
Orlando, FL 32806-1110
Phone (407) 896-1100

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
79.91 of 100Reported as group
Quality
61.18
Promoting interoperability
100
Improvement activities
40
Cost
71.86

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME142672FLMDInternal Medicine Physician
289944NYMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Orlando Health, Inc. Current Accepting new patients
Orlando Health Medical Group Inc CurrentSince Nov 1, 2019 Accepting new patients
Orlando Health Medical Group Inc Internal Medicine CurrentSince Nov 1, 2019 Accepting new patients

Locations

32 W Gore St
Orlando, FL 32806
Phone (321) 841-3820

86 Underwood St
Orlando, FL 32806
Phone (321) 841-5142

Networks

  • Freedom Health HMO Network
  • Optimum HealthCare HMO Network

Interoperability endpoints

  • Direct secure messaging: jgupta25940@orlandohealth.medalliesdirect.net

Organizations & group practices 3

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": "1396483200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1569542400000",
    "number": "1174941413",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "86 W UNDERWOOD ST",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328061110",
            "telephone_number": "888-912-3648",
            "fax_number": "321-841-4085"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "86 W UNDERWOOD ST",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328061110",
            "telephone_number": "888-912-3648",
            "fax_number": "321-841-4085"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "601 Elmwood Avenue Box Med/Hmd",
            "address_purpose": "LOCATION",
            "city": "Rochester",
            "state": "NY",
            "postal_code": "146420001",
            "country_code": "US",
            "telephone_number": "585-275-4912",
            "fax_number": "585-276-2144",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GUPTA",
        "first_name": "JESSICA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-04-03",
        "last_updated": "2019-09-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "289944",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ME142672",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orlando, FL

Sources for this page

Verify at the official NPI Registry.