Bal K Gupta MD PC

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

4301037633 Issued in MI

Legal business name

BAL K GUPTA MD PC

Practice address

11900 E Twelve Mile Rd
Suite 111
Warren, MI 48093-3472

Phone

(586) 573-5300

Fax

(586) 573-5304

NPI assigned

Sep 27, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Bal Krishan Gupta, MDNPI 1225041353

Title

President

Phone

(586) 573-5300

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MI

Enrollment records 1

Locations

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Bal Krishan Gupta, MD

  • Psychiatry Physician
  • Warren, MI
  • NPI 1225041353
  Medicare reassignment Care Compare group NPD Authorized official
• Vijaya Gopal Kotha, MD

  • Psychiatry Physician
  • Mount Clemens, MI
  • NPI 1386657427
  Medicare reassignment Care Compare group NPD
• Chilakamarri Ramesh, MD

  • Psychiatry Physician
  • Royal Oak, MI
  • NPI 1578575106
  Medicare reassignment NPD
• Nicole M Vichunas, PA-C

  • Physician Assistant
  • Saint Clair Shores, MI
  • NPI 1386996858
  Medicare reassignment
• Lily Ann Marie Tencza, MD

  • Psychiatry Physician
  • The Villages, FL
  • NPI 1740206168
  NPD (past)

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

{
    "created_epoch": "1159315200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1306937339",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11900 E TWELVE MILE RD",
            "address_2": "SUITE 111",
            "city": "WARREN",
            "state": "MI",
            "postal_code": "480933472",
            "telephone_number": "586-573-5300",
            "fax_number": "586-573-5304"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11900 E TWELVE MILE RD",
            "address_2": "SUITE 111",
            "city": "WARREN",
            "state": "MI",
            "postal_code": "480933472",
            "telephone_number": "586-573-5300",
            "fax_number": "586-573-5304"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BAL K GUPTA MD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-27",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "GUPTA",
        "authorized_official_first_name": "BAL",
        "authorized_official_middle_name": "KRISHAN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "586-573-5300",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "MI",
            "license": "4301037633",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Manisha Kaur Bajwa, PHARM.D., CGP
• Ireneusz Bak
• Autumn K Baker
• Brittany Baker
• Joyce Ellen Baker, LBSW
• Balanced Podiatry Care
• Ballo DDS PC
• Maria Anna Baltarowich, D.D.S.
• Erica Nicole Balysh, D.O.
• Rachel Banados

• Psychiatry Physician in Warren, MI
• Providers in Warren, MI by specialty
• Psychiatry Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.