NPIMap

Individual provider Active NPI

Rajeev Gupta, MD

  • Geriatric Medicine (Family Medicine) Physician
  • Morristown, TN
National Provider Identifier
1225089725
Registry record updated May 28, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Geriatric Medicine (Family Medicine) PhysicianTaxonomy code 207QG0300X
License
MD0000035645 Issued in TN
Practice address
1621 W Morris Blvd Ste C
Morristown, TN 37813-2832
Phone
(423) 317-7412
Fax
(423) 317-7415
NPI assigned
May 12, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 28, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Geriatric Medicine (Family Medicine) Physician 207QG0300X MD0000035645 TN Primary

Addresses

Primary practice location

1621 W Morris Blvd Ste C
Morristown, TN 37813-2832

Mailing address

1621 W Morris Blvd Ste C
Morristown, TN 37813-2832
Phone (423) 317-7412

Other identifiers 2

IdentifierTypeStateIssuer
3879184MedicaidTN
080190473OtherTNRAILROAD MEDICARE

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address gupta.rajeev@covenanthealth.cernerdirect.com Health Information Exchange (HIE) Morristown Hamblen Hospital Association

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100217000594 TN Practitioner - Family PracticePractitioner - Geriatric Medicine 8022150515 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family PracticeAlso: Geriatric Medicine
Education
Other, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Primary Care and Geriatrics, PCGroup PAC ID 3577605054, 7 clinicians

Practice addresses (Care Compare)

711 McFarland St
Morristown, TN 37814-3977
Phone (423) 317-7412

Hospital & facility affiliations

  • University of TN Medical Center Home Health Serv Home health agency, Morristown, TN, CCN 447500
  • Amedisys Home Health Care Home health agency, Morristown, TN, CCN 447190
  • Smoky Mountain Home Health and Hospice, Inc Home health agency, Newport, TN, CCN 447195
  • Amedisys Home Health Care Home health agency, Knoxville, TN, CCN 447312
  • Centerwell Home Health Home health agency, Knoxville, TN, CCN 447111
  • Smoky Mountain Home Health and Hospice, I N C Hospice, Newport, TN, CCN 441550
  • Morristown Hamblen Hospital Association Hospital, Morristown, TN, CCN 440030
  • Tennova Healthcare-Jefferson Memorial Hospital Hospital, Jefferson City, TN, CCN 440056
  • The Heritage Center Nursing home, Morristown, TN, CCN 445215
  • Life Care Center of Morristown Nursing home, Morristown, TN, CCN 445314

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as individual
Quality
98.56
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision1-10
Removal of skin lesions1-10
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD0000035645TNMDGeriatric Medicine (Family Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Primary Care and Geriatrics, PC Geriatric Medicine CurrentSince Oct 7, 2002 Accepting new patients
Life Care Centers of America, Inc. Past Accepting new patients
Life Care Centers of America, Inc. Past Accepting new patients
Morristown Hamblen Hospital Association Past Accepting new patients
Primary Care & Geriatrics Past Accepting new patients

Locations

908 W 4th North St
Morristown, TN 37814
Phone (423) 492-9000

739 E 2nd North St
Morristown, TN 37814
Phone (423) 581-7075

1621 W Morris Blvd
Ste C
Morristown, TN 37813
Phone (423) 317-7412

711 McFarland St
Morristown, TN 37814
Phone (423) 317-7412

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 10

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": "1147392000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1622160000000",
    "number": "1225089725",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1621 W MORRIS BLVD STE C",
            "city": "MORRISTOWN",
            "state": "TN",
            "postal_code": "378132832",
            "telephone_number": "423-317-7412",
            "fax_number": "423-317-7415"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1621 W MORRIS BLVD STE C",
            "city": "MORRISTOWN",
            "state": "TN",
            "postal_code": "378132832",
            "telephone_number": "423-317-7412",
            "fax_number": "423-317-7415"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUPTA",
        "first_name": "RAJEEV",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-05-12",
        "last_updated": "2021-05-28",
        "certification_date": "2021-05-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207QG0300X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Geriatric Medicine",
            "state": "TN",
            "license": "MD0000035645",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3879184",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "080190473",
            "state": "TN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "gupta.rajeev@covenanthealth.cernerdirect.com",
            "affiliation": "Y",
            "affiliationName": "Morristown Hamblen Hospital Association",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "address_1": "908 West Fourth North Street",
            "city": "Morristown",
            "state": "TN",
            "country_code": "US",
            "postal_code": "378143894",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Morristown, TN

Sources for this page

Verify at the official NPI Registry.