Individual provider Active NPI

Prabhas Gupta, MD

  • Internal Medicine Physician
  • Sacramento, CA
National Provider Identifier
1275976037
Registry record updated Oct 25, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
A139676 Issued in CA
Practice address
1201 Alhambra Blvd Ste 400
Sacramento, CA 95816
Phone
(916) 733-5090
Fax
(916) 733-9815
NPI assigned
Apr 11, 2013
Last updated
Oct 25, 2019By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 25, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X NU
Internal Medicine Physician 207R00000X A139676 CA Primary

Addresses

Primary practice location

1201 Alhambra Blvd Ste 400
Sacramento, CA 95816

Mailing address

PO Box 255228
Sacramento, CA 95865-5228
Phone (800) 400-0701

Other practice location 1

507 Main Street
Johnson City, NY 13790
Phone (607) 763-8008

Other practice location 2

507 Main Street
Johnson City, NY 13790
Phone (607) 763-8008

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
I20161115000995 CA Practitioner - Internal Medicine 9931331469 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Sutter Valley Medical FoundationGroup PAC ID 9830094515, 2,473 clinicians
Marshall Medical CenterGroup PAC ID 7517875859, shared by 7 NPIs, 168 clinicians

Practice addresses (Care Compare)

2 Medical Plaza Dr
Roseville, CA 95661-3042

2800 L St
Sacramento, CA 95816-5616

3100 Douglas Blvd
Roseville, CA 95661-3866
Phone (916) 774-8500

4201 Town Ctr Blvd
BLDG D
El Dorado Hills, CA 95762-7100
Phone (916) 905-6378

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions28
Removal or shaving of skin growth1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A139676CAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Permanente Medical Group Inc Internal Medicine Current Accepting new patients
Sutter Valley Medical Foundation Internal Medicine CurrentSince Nov 11, 2019 Accepting new patients
Permanente Medical Group, Inc CurrentSince Oct 1, 2016 Accepting new patients
Permanente Medical Group Inc Internal Medicine CurrentSince Oct 1, 2016 Accepting new patients
Sutter Valley Medical Foundation Internal Medicine Current Accepting new patients
Sutter Valley Medical Foundation CurrentSince Nov 11, 2019 Accepting new patients
Sutter Regional Medical Foundation Internal Medicine Past Accepting new patients
Genadij Sienkiewicz MD, PC Past Accepting new patients
United Health Services Hospitals, Inc. PastSince Jan 31, 2004 Accepting new patients

Locations

750 Auburn Ravine Rd
Auburn, CA 95603
Phone (530) 823-6131

39400 Paseo Padre Pkwy
Fremont, CA 94538
Phone (510) 248-3000

4753 W Shaw Ave
Ste 101
Fresno, CA 93722
Phone (559) 277-8738

900 N Douty St
Hanford, CA 93230
Phone (559) 587-9014

101 Monroe St
Petaluma, CA 94954
Phone (707) 763-4109

1150 Veterans Blvd
Redwood City, CA 94063
Phone (650) 299-2015

901 Nevin Ave
Richmond, CA 94801
Phone (510) 307-1500

930 W Main St
Ripon, CA 95366
Phone (209) 599-4221

1201 Alhambra Blvd
Ste 400
Sacramento, CA 95816
Phone (916) 733-5090

2750 Gateway Oaks Dr
Ste 150
Sacramento, CA 95833
Phone (916) 887-7398

2800 L St
Ste 500
Sacramento, CA 95816
Phone (916) 454-6850

2200 Ofarrell St
San Francisco, CA 94115
Phone (415) 202-2000

710 Lawrence Expy
Santa Clara, CA 95051
Phone (408) 236-6400

7373 West Ln
Stockton, CA 95210
Phone (209) 476-2000

975 Sereno Dr
Vallejo, CA 94589
Phone (707) 651-1000

320 N Crawford St
Willows, CA 95988
Phone (530) 934-2834

Interoperability endpoints

  • Direct secure messaging: pgupta465392@hisp.ehr.sutterhealth.org

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

Hospital & facility affiliations 6

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": "1365638400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1571961600000",
    "number": "1275976037",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 255228",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958655228",
            "telephone_number": "800-400-0701"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1201 ALHAMBRA BLVD STE 400",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "95816",
            "telephone_number": "916-733-5090",
            "fax_number": "916-733-9815"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "507 Main Street",
            "address_purpose": "LOCATION",
            "city": "Johnson City",
            "state": "NY",
            "postal_code": "13790",
            "country_code": "US",
            "telephone_number": "607-763-8008",
            "fax_number": "607-763-8019",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "507 Main Street",
            "address_purpose": "LOCATION",
            "city": "Johnson City",
            "state": "NY",
            "postal_code": "13790",
            "country_code": "US",
            "telephone_number": "607-763-8008",
            "fax_number": "607-763-8019",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GUPTA",
        "first_name": "PRABHAS",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-04-11",
        "last_updated": "2019-10-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A139676",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sacramento, CA

Sources for this page

Verify at the official NPI Registry.