Organization Active NPI

Tarsem L. Gupta, MD, PC

  • Pulmonary Disease Physician
  • Stockbridge, GA
National Provider Identifier
1194884247
Registry record updated Apr 30, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pulmonary Disease PhysicianTaxonomy code 207RP1001X
License
028410 Issued in GA
Legal business name
TARSEM L. GUPTA, MD, PC
Doing business as
ATLANTA PULMONARY CARE
Practice address
830 Eagles Landing Pkwy
Suite 101
Stockbridge, GA 30281-7384
Phone
(770) 506-7171
Fax
(770) 506-8406
NPI assigned
Dec 6, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 30, 2008

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

Authorized official

Name
Mrs. Kiran Gupta
Title
Office Manager
Phone
(770) 506-7171

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pulmonary Disease PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RP1001X 028410 GA Primary

Addresses

Primary practice location

830 Eagles Landing Pkwy
Suite 101
Stockbridge, GA 30281-7384

Mailing address

830 Eagles Landing Pkwy
Suite 101
Stockbridge, GA 30281-7384
Phone (770) 506-7171

Other identifiers 6

IdentifierTypeStateIssuer
297160MedicaidGA
000401178EMedicaidGA
000401178DMedicaidGA
592806OtherGABCBS OF GEORGIA
300028737AMedicaidGA
01000147MedicaidGA

Other names 1

  • ATLANTA PULMONARY CARE Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080502000150 GA Part B Supplier - Clinic/Group Practice 4486733425 Receives reassigned benefits from 1 practitioner
Practice locations: Stockbridge, GA

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1165363200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1209513600000",
    "number": "1194884247",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "830 EAGLES LANDING PKWY",
            "address_2": "SUITE 101",
            "city": "STOCKBRIDGE",
            "state": "GA",
            "postal_code": "302817384",
            "telephone_number": "770-506-7171",
            "fax_number": "770-506-8406"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "830 EAGLES LANDING PKWY",
            "address_2": "SUITE 101",
            "city": "STOCKBRIDGE",
            "state": "GA",
            "postal_code": "302817384",
            "telephone_number": "770-506-7171",
            "fax_number": "770-506-8406"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TARSEM L. GUPTA, MD, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-06",
        "last_updated": "2008-04-30",
        "status": "A",
        "authorized_official_last_name": "GUPTA",
        "authorized_official_first_name": "KIRAN",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "770-506-7171",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "207RP1001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "GA",
            "license": "028410",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "297160",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000401178E",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000401178D",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF GEORGIA",
            "identifier": "592806",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "300028737A",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01000147",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "ATLANTA PULMONARY CARE",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Stockbridge, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 30, 2008; 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.