Active NPI
Raksha R Gupta, MD
- Pediatrics Physician
- Hackensack, NJ
National Provider Identifier
1295816270
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- MA55012
- Practice address
- 920 Main St
Hackensack, NJ 07601 - Phone
- (201) 488-2200
- Fax
- (201) 488-0211
- NPI assigned
- Oct 18, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | MA55012 | NJ | Primary |
Addresses
Primary practice location
920 Main St
Hackensack, NJ 07601
Mailing address
920 Main St
Hackensack, NJ 07601
Phone (201) 488-2200
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MA55012 | NJ | MD | Pediatrics Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Nymhc FPP Nephrology | Past | Accepting new patients | |
| Riverside Medical Group | Past | Accepting new patients |
Interoperability endpoints
- rgupta77238@direct.optum.com
Organizations & group practices 2
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.
-
- Nurse Practitioner
- Secaucus, NJ
- NPI 1053867598
-
- Nephrology Physician
- New York, NY
- NPI 1306878657
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1161129600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1317254400000",
"number": "1295816270",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "920 MAIN ST",
"city": "HACKENSACK",
"state": "NJ",
"postal_code": "07601",
"telephone_number": "201-488-2200",
"fax_number": "201-488-0211"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "920 MAIN ST",
"city": "HACKENSACK",
"state": "NJ",
"postal_code": "07601",
"telephone_number": "201-488-2200",
"fax_number": "201-488-0211"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GUPTA",
"first_name": "RAKSHA",
"middle_name": "R",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-10-18",
"last_updated": "2011-09-29",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "NJ",
"license": "MA55012",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Hackensack, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 29, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.