Active NPI
Pooja Gupta, MD
- Pulmonary Disease Physician
- Memphis, TN
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pulmonary Disease Physician
- License
- 66968
- Practice address
- 880 Madison Ave
Memphis, TN 38103-3409 - Phone
- (901) 545-6969
- Fax
- (901) 545-4748
- NPI assigned
- May 17, 2007
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 2006013138 | MO | |
| Pulmonary Disease Physician | 207RP1001X | 6462 | NE | |
| Pulmonary Disease Physician | 207RP1001X | 66968 | TN | Primary |
Addresses
Primary practice location
880 Madison Ave
Memphis, TN 38103-3409
Mailing address
900 Main St Ste 630
Peoria, IL 61602-5024
Phone (309) 672-4433
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 036123061 | Other | IL | LICENSE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IL, TN
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 2
Care Compare profile
Medicare Care Compare- Specialty
- Pulmonary Disease
- Education
- Other, 2005
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
880 Madison Ave
Memphis, TN 38103-3409
Phone (901) 545-6969
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2006013138 | MO | MD | Internal Medicine Physician |
| 6462 | NE | MD | Pulmonary Disease Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Methodist Medical Center of Illinois | Current | Accepting new patients | |
| Ut Regional One Physicians Inc | Current | Accepting new patients | |
| Ut Regional One Physicians Inc | Internal Medicine | Current | Accepting new patients |
| Cook County | Internal Medicine | Current | Accepting new patients |
| Methodist Medical Center of Illinois | Current | Accepting new patients | |
| Cook County | Current | Accepting new patients | |
| Cook County | Current | Accepting new patients | |
| Proctor Health Systems | Internal Medicine | Current | Accepting new patients |
| Methodist Medical Center of Illinois | Current | Accepting new patients |
Locations
1506 W Garfield Ave
Bartonville, IL 61607
Phone (309) 697-2416
1901 W Harrison St
Chicago, IL 60612
Phone (312) 864-5100
500 E 51st St
Chicago, IL 60615
Phone (312) 572-2000
120 NE Glen Oak Ave
Ste 400
Peoria, IL 61603
Phone (309) 671-3519
5401 N Knoxville Ave
Ste 400
Peoria, IL 61614
Phone (309) 691-6610
900 Main St
Ste 630
Peoria, IL 61602
Phone (309) 627-4433
815 Main St
Ste A1
Peoria, IL 61602
221 NE Glen Oak Ave
Peoria, IL 61636
Phone (309) 672-4281
815 Main St
Ste A
Peoria, IL 61602
Phone (309) 672-4986
880 Madison Ave
Memphis, TN 38103
Phone (901) 515-3500
877 Jefferson Ave
Memphis, TN 38103
Phone (901) 448-5893
6215 Humphreys Blvd
Ste 201
Memphis, TN 38120
Phone (901) 866-8085
Organizations & group practices 9
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.
-
- General Acute Care Hospital
- Chicago, IL
- NPI 1588612832
-
- Rehabilitation Hospital Unit
- Peoria, IL
- NPI 1982656575
-
- Anesthesiology Physician
- Memphis, TN
- NPI 1285042028
-
- Multi-Specialty Clinic/Center
- Chicago, IL
- NPI 1831219450
-
- General Acute Care Hospital
- Peoria, IL
- NPI 1164474755
-
- Psychiatric Hospital Unit
- Peoria, IL
- NPI 1275583155
Hospital & facility affiliations 1
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Memphis, TN
- NPI 1144213117
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1179360000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1674691200000",
"number": "1205044062",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "900 MAIN ST STE 630",
"city": "PEORIA",
"state": "IL",
"postal_code": "616025024",
"telephone_number": "309-672-4433"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "880 MADISON AVE",
"city": "MEMPHIS",
"state": "TN",
"postal_code": "381033409",
"telephone_number": "901-545-6969",
"fax_number": "901-545-4748"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GUPTA",
"first_name": "POOJA",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-05-17",
"last_updated": "2023-01-26",
"certification_date": "2023-01-26",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "MO",
"license": "2006013138",
"primary": false
},
{
"code": "207RP1001X",
"taxonomy_group": "",
"desc": "Internal Medicine, Pulmonary Disease",
"state": "NE",
"license": "6462",
"primary": false
},
{
"code": "207RP1001X",
"taxonomy_group": "",
"desc": "Internal Medicine, Pulmonary Disease",
"state": "TN",
"license": "66968",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LICENSE",
"identifier": "036123061",
"state": "IL"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Memphis, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 26, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.