NPIMap

Individual provider Active NPI

Amit Ajay Gupta, M.D.

  • Family Medicine Physician
  • Las Cruces, NM
National Provider Identifier
1306266523
Registry record updated Jul 29, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
RS2016-0646 Issued in NM
Practice address
2450 S Telshor Blvd
Las Cruces, NM 88011-5069
Phone
(575) 521-5385
NPI assigned
Apr 28, 2014
Last updated
Jul 29, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 29, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X RS2016-0646 NM Primary

Addresses

Primary practice location

2450 S Telshor Blvd
Las Cruces, NM 88011-5069

Mailing address

2450 S Telshor Blvd
Las Cruces, NM 88011-5069
Phone (575) 521-5385

Other practice location 1

3115 S Price Rd
Chandler, AZ 85248-3544
Phone (888) 488-7640

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NM, AZ2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20191106002790 NM Practitioner - Family PracticePractitioner - Emergency Medicine 9133551427 Reassigns benefits to 3 organizations
I20220119002132 AZ Practitioner - Family Practice 9133551427 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Pioneer Hospitalists, PLLCGroup PAC ID 0941290290, 50 clinicians

Practice addresses (Care Compare)

3555 S Val Vista Dr
Gilbert, AZ 85297-7323
Phone (888) 488-7640

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
58.85 of 100Reported as individual
Quality
60.24
Improvement activities
0
Cost
69.29

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
RS2016-0646NMMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Pioneer Hospitalists, PLLC CurrentSince Dec 12, 2021 Accepting new patients
Emergency Staffing Solutions Inc CurrentSince Dec 30, 2019 Accepting new patients
Southwest Emergency Medical Associates of NM PC CurrentSince Oct 1, 2019 Accepting new patients
Northwest Hospital Medicine Physicians LLC CurrentSince Mar 1, 2020 Accepting new patients
Agh Mesa LLC Past Accepting new patients

Locations

3100 W Ray Rd
Ste 201
Chandler, AZ 85226
Phone (269) 312-1446

3115 S Price Rd
Chandler, AZ 85248
Phone (480) 855-4011

3555 S Val Vista Dr
Gilbert, AZ 85297
Phone (480) 434-4356

601 Martin Luther King Ave NE
Albuquerque, NM 87102
Phone (505) 727-8040

2450 S Telshor Blvd
Las Cruces, NM 88011
Phone (505) 522-8641

3917 West Rd
Los Alamos, NM 87544
Phone (505) 661-9584

800 E 9th Ave
Truth Or Consequences, NM 87901
Phone (505) 743-1270

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Hospice at Home of Arizona, LLCMesa, AZ, CCN 031623 Hospice Contracted Managing Employee Jul 1, 2023

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

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 26

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 26

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1398643200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1627516800000",
    "number": "1306266523",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2450 S TELSHOR BLVD",
            "city": "LAS CRUCES",
            "state": "NM",
            "postal_code": "880115069",
            "telephone_number": "575-521-5385"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2450 S TELSHOR BLVD",
            "city": "LAS CRUCES",
            "state": "NM",
            "postal_code": "880115069",
            "telephone_number": "575-521-5385"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3115 S Price Rd",
            "address_purpose": "LOCATION",
            "city": "Chandler",
            "state": "AZ",
            "postal_code": "852483544",
            "country_code": "US",
            "telephone_number": "888-488-7640",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GUPTA",
        "first_name": "AMIT",
        "middle_name": "AJAY",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-04-28",
        "last_updated": "2021-07-29",
        "certification_date": "2021-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NM",
            "license": "RS2016-0646",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Cruces, NM

Sources for this page

Verify at the official NPI Registry.