Individual provider Active NPI

Mukesh Bhavdutt Gupta, M.D.

  • Anesthesiology Physician
  • Riverside, CA
National Provider Identifier
1255369542
Registry record updated May 5, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
A70036 Issued in CA
Practice address
4049 Almond St Ste 102
Riverside, CA 92501-3570
Phone
(951) 781-3945
Fax
(951) 781-3661
NPI assigned
Jun 28, 2006
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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X A70036 CA Primary

Addresses

Primary practice location

4049 Almond St Ste 102
Riverside, CA 92501-3570

Mailing address

210 N Tustin Ave
Santa Ana, CA 92705-3807
Phone (714) 347-1010

Other identifiers 1

IdentifierTypeStateIssuer
00A700360MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20040329001776 CA Practitioner - Anesthesiology 4183516404 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
Other, 1977
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Darin Rentz DO PCGroup PAC ID 7315333853, 131 clinicians

Practice addresses (Care Compare)

4445 Magnolia Ave
Riverside, CA 92501-4135
Phone (951) 788-3000

600 N Highland Springs Ave
Banning, CA 92220-3046
Phone (951) 845-1121

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A70036CAMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Darin Rentz DO PC Anesthesiology CurrentSince Sep 1, 2024 Accepting new patients
Inland Surgery Center Inc PastSince Jul 23, 2021 Accepting new patients
Anesthesia Partners of North Valley Anesthesiology Past Accepting new patients
Oasis Surgery Center, LP Past Accepting new patients

Locations

600 N Highland Springs Ave
Banning, CA 92220
Phone (833) 443-6287

1620 Laurel Ave
Redlands, CA 92373
Phone (909) 793-4701

350 Terracina Blvd
Redlands, CA 92373
Phone (909) 335-5500

4445 Magnolia Ave
Riverside, CA 92501
Phone (800) 498-7156

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

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": "1151452800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1399248000000",
    "number": "1255369542",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "210 N TUSTIN AVE",
            "city": "SANTA ANA",
            "state": "CA",
            "postal_code": "927053807",
            "telephone_number": "714-347-1010",
            "fax_number": "714-647-1245"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4049 ALMOND ST STE 102",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925013570",
            "telephone_number": "951-781-3945",
            "fax_number": "951-781-3661"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUPTA",
        "first_name": "MUKESH",
        "middle_name": "BHAVDUTT",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-28",
        "last_updated": "2014-05-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "CA",
            "license": "A70036",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A700360",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Riverside, CA

Sources for this page

Verify at the official NPI Registry.