Individual provider Active NPI

Sushil Gupta, M.D.

  • Pulmonary Disease Physician
  • New Haven, CT
National Provider Identifier
1174954960
Registry record updated May 5, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pulmonary Disease PhysicianTaxonomy code 207RP1001X
License
36095 Issued in CT
Practice address
136 Sherman Ave
Suite#504
New Haven, CT 06511-5238
Phone
(203) 772-2499
Fax
(203) 785-8818
NPI assigned
Dec 5, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 5, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pulmonary Disease Physician 207RP1001X 36095 CT Primary
Internal Medicine Physician 207R00000X 036095 CT

Addresses

Primary practice location

136 Sherman Ave
Suite#504
New Haven, CT 06511-5238

Mailing address

136 Sherman Ave
Suite#504
New Haven, CT 06511-5238
Phone (203) 772-2499

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT
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
I20040816000152 CT Practitioner - Pulmonary DiseasePractitioner - Critical Care (Intensivists) 3678546033 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
036095CTMDInternal Medicine Physician
36095CTMDPulmonary Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Pulmonary Care, PC Pulmonary Disease CurrentSince Mar 25, 2014 Accepting new patients
Complete Wound Care LLC PastSince Oct 1, 2025 Accepting new patients

Locations

2447 Whitney Ave
Ste 202
Hamden, CT 06518
Phone (203) 288-8300

136 Sherman Ave
Ste 504
New Haven, CT 06511
Phone (203) 684-2111

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1386201600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1399248000000",
    "number": "1174954960",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "136 SHERMAN AVE",
            "address_2": "SUITE#504",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "065115238",
            "telephone_number": "203-772-2499",
            "fax_number": "203-785-8818"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "136 SHERMAN AVE",
            "address_2": "SUITE#504",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "065115238",
            "telephone_number": "203-772-2499",
            "fax_number": "203-785-8818"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUPTA",
        "first_name": "SUSHIL",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-12-05",
        "last_updated": "2014-05-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "CT",
            "license": "36095",
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CT",
            "license": "036095",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New Haven, CT

Sources for this page

Verify at the official NPI Registry.